Provider Demographics
NPI:1265463863
Name:PLEASANTS, GREGORY J (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:J
Last Name:PLEASANTS
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 1:2600 E PARHAM RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-2932
Mailing Address - Country:US
Mailing Address - Phone:804-262-2333
Mailing Address - Fax:804-262-0848
Practice Address - Street 1:2600 E PARHAM RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-2932
Practice Address - Country:US
Practice Address - Phone:804-262-2333
Practice Address - Fax:804-262-0848
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101036362207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA147956OtherSOUTHERN HEALTH SERVICES
VA2121063OtherMAMSI
VAC06778OtherGROUP PTAN
VA4076390OtherAETNA LIFE
VA4076390OtherAETNA HMO
VA110237465OtherRAILROAD MEDICARE
VA005865905Medicaid
VA440821OtherANTHEM BCBS OF VA
VA6290706OtherCIGNA
VAC07050OtherGROUP PTAN
VA46052OtherSENTARA
VAB06459Medicare UPIN