Provider Demographics
NPI:1225004096
Name:BILLETT, TODD EVANS (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:EVANS
Last Name:BILLETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10710 MIDLOTHIAN TURNPIKE
Mailing Address - Street 2:STE 200
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4759
Mailing Address - Country:US
Mailing Address - Phone:804-897-2100
Mailing Address - Fax:804-897-9074
Practice Address - Street 1:10710 MIDLOTHIAN TURNPIKE
Practice Address - Street 2:STE 200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4759
Practice Address - Country:US
Practice Address - Phone:804-897-2100
Practice Address - Fax:804-897-9074
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043119207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6213171Medicaid
E00480Medicare UPIN
VA6213171Medicaid