Provider Demographics
NPI:1477658730
Name:OSPINA, RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:OSPINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 79429
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0429
Mailing Address - Country:US
Mailing Address - Phone:301-624-5730
Mailing Address - Fax:301-624-5731
Practice Address - Street 1:1500 N BEAUREGARD ST STE 300
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1715
Practice Address - Country:US
Practice Address - Phone:703-845-1500
Practice Address - Fax:703-845-1300
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012343902084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7997474OtherAETNA
DC1505687000OtherUS DEPT OF LABOR W/C
VA289049OtherANTHEM
VA283597OtherAMERIGROUP
VA612326OtherNCPPO
VAP00030237OtherRAILROAD MEDICARE
VA2105516OtherALLIANCE/MAMSI
VA007119453Medicaid
DC4571 0006OtherCF BC BS DC
VA2281433OtherUNITED HEALTHCARE
DC1505687000OtherUS DEPT OF LABOR W/C