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Individual

DR. RICHARD TATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1800 GLENSIDE DR, SUITE 101, RICHMOND, VA 23226-3769
(804) 288-3001
(804) 673-5614
Mailing address
1800 GLENSIDE DR, STE 105, RICHMOND, VA 23226-3769
(804) 288-0399
(804) 285-0088

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
0101048386
VA
207Q00000X
Family Medicine Physician
Primary
0101048386
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005811015
VA
01
110162592
MEDICARE RAILROAD
VA
01
141502
ANTHEM
VA
05
1851373013
VA
Enumeration date
11/15/2005
Last updated
01/31/2012
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