Provider Demographics
NPI:1376578765
Name:DIGRAZIA, JOHN MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARK
Last Name:DIGRAZIA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8001 FRANKLIN FARMS DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5108
Mailing Address - Country:US
Mailing Address - Phone:804-521-5800
Mailing Address - Fax:804-545-4340
Practice Address - Street 1:7401 BEAUFONT SPRINGS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-5520
Practice Address - Country:US
Practice Address - Phone:804-323-5011
Practice Address - Fax:804-323-5120
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2014-07-09
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Provider Licenses
StateLicense IDTaxonomies
VA0101035552207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA60035366OtherRAILROAD MEDICARE
VA6079067Medicaid
VA103862OtherANTHEM/VA HEALTHKEEPERS
VA311468OtherMAMSI
VA276346OtherANTHEM/VA HEALTHKEEPERS
VA4063359OtherAETNA/US HEALTHCARE
VA44217OtherOPTIMA HEALTH
VA56362OtherSOUTHERN HEALTH
VA110911OtherANTHEM/VA HEALTHKEEPERS
VA27413300OtherFEDERAL BLACK LUNG
VA276261OtherANTHEM/VA HEALTHKEEPERS
VA110923OtherANTHEM/VA HEALTHKEEPERS
VA111022OtherANTHEM/VA HEALTHKEEPERS
VA1369207OtherCIGNA
VA110929OtherANTHEM/VA HEALTHKEEPERS
VA500551OtherAETNA/US HEALTHCARE HMO
VA110923OtherANTHEM/VA HEALTHKEEPERS
VA500551OtherAETNA/US HEALTHCARE HMO