Provider Demographics
NPI:1275226086
Name:GERGES, MILAD N
Entity Type:Individual
Prefix:
First Name:MILAD
Middle Name:N
Last Name:GERGES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 PATTERSON AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-6110
Mailing Address - Country:US
Mailing Address - Phone:804-585-8277
Mailing Address - Fax:
Practice Address - Street 1:1356 GASKINS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-4919
Practice Address - Country:US
Practice Address - Phone:804-740-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202221248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist