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Individual

RICHARD MICHAEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.-C

Contact information

Practice address
411 W RANDOLPH RD, HOPEWELL, VA 23860-2938
(804) 452-3624
Mailing address
PO BOX 17572, BALTIMORE, MD 21297-1572
(866) 916-5259
(231) 922-4030

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110840638
VA

Other

Enumeration date
07/17/2006
Last updated
05/07/2008
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