Provider Demographics
NPI:1336320118
Name:RICHARD D NEMETH MD PLLC
Entity Type:Organization
Organization Name:RICHARD D NEMETH MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:NEMETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-317-9500
Mailing Address - Street 1:PO BOX 577
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22038-0577
Mailing Address - Country:US
Mailing Address - Phone:703-317-9500
Mailing Address - Fax:
Practice Address - Street 1:5946 RICHMOND HWY
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22303-1871
Practice Address - Country:US
Practice Address - Phone:703-317-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058037207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG01815Medicare PIN