Provider Demographics
NPI:1558333252
Name:BIKOWSKI, RICHARD M (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:BIKOWSKI
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:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-397-6344
Mailing Address - Fax:757-606-1185
Practice Address - Street 1:3640 HIGH ST STE 3B
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3213
Practice Address - Country:US
Practice Address - Phone:757-397-6344
Practice Address - Fax:757-606-1185
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034013207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherAETNA
VAPAROtherUSA MANAGED CARE
VA-002 -003OtherTRICARE/CHAMPUS
NC05185OtherBC/BS
VAPAROtherVA HEALTH NETWORK
VAPAROtherMULTIPLAN
VAPAROtherCORVEL/CORCARE
VA005612578Medicaid
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
NC8905185Medicaid
VA434839OtherANTHEM
VA005624801Medicaid
VA21009OtherSENTARA
VA2180443OtherUHC/MAMSI
VAPAROtherCIGNA
VAB08147Medicare UPIN
VA434839OtherANTHEM
NC8905185Medicaid