Individual
GIACOMO A RICCIARELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
263 MCLAWS CIRCLE, SUITE 105, WILLIAMSBURG, VA 23185-5629
(757) 941-5600
(757) 564-0557
Mailing address
PO BOX 1239, TROY, MI 48099-1239
(248) 824-6600
(855) 618-6655
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101029718
VA
208600000X
Surgery Physician
0101029718
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
440432
ANTHEM
VA
01
—
52244
SENTARA HEALTHCARE
VA
05
—
7305737
—
VA
Enumeration date
02/02/2007
Last updated
02/28/2020
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