Provider Demographics
NPI:1114925575
Name:PEPPIATT, HARRY BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:BRIAN
Last Name:PEPPIATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:H.
Other - Middle Name:BRIAN
Other - Last Name:PEPPIATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:671 HIOAKS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225
Mailing Address - Country:US
Mailing Address - Phone:804-272-5814
Mailing Address - Fax:804-560-0232
Practice Address - Street 1:671 HIOAKS RD
Practice Address - Street 2:SUITE B
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225
Practice Address - Country:US
Practice Address - Phone:804-272-5814
Practice Address - Fax:804-560-0232
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043540207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6024718Medicaid
VA110002693Medicare ID - Type Unspecified
VA6024718Medicaid