Individual
RICHARD LEROY BENNETT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1510 NORTH 28TH STREET, SUITE 207, RICHMOND, VA 23223
(804) 649-0044
(804) 649-0758
Mailing address
1510 NORTH 28TH STREET, SUITE 207, RICHMOND, VA 23223
(804) 649-0044
(804) 649-0758
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101233413
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6737188
—
VA
Enumeration date
12/06/2006
Last updated
07/08/2007
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