Provider Demographics
NPI:1306820048
Name:PASCHAL, JAMES RICHARD (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RICHARD
Last Name:PASCHAL
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 1:330 E BAYVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-5205
Mailing Address - Country:US
Mailing Address - Phone:757-583-1200
Mailing Address - Fax:757-583-1682
Practice Address - Street 1:330 E BAYVIEW BLVD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23503-5205
Practice Address - Country:US
Practice Address - Phone:757-583-1200
Practice Address - Fax:757-583-1682
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101035974207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010014877OtherMC RR
VA028920OtherANTHEM
VA010014877OtherMC RR
VA080001110Medicare ID - Type Unspecified