Provider Demographics
NPI:1053387266
Name:RICHARDS, PAUL D (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2013 JEFFERSON ST SW
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-2419
Mailing Address - Country:US
Mailing Address - Phone:540-982-0237
Mailing Address - Fax:540-982-0103
Practice Address - Street 1:1900 ELECTRIC RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7474
Practice Address - Country:US
Practice Address - Phone:540-774-8660
Practice Address - Fax:540-774-9195
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2007-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101038197207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5854610Medicaid
VA5854610Medicaid