Provider Demographics
NPI:1588637482
Name:RICHMOND SURGICAL GROUP INC
Entity Type:Organization
Organization Name:RICHMOND SURGICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-285-4585
Mailing Address - Street 1:8921 THREE CHOPT RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4601
Mailing Address - Country:US
Mailing Address - Phone:804-285-4585
Mailing Address - Fax:804-285-7015
Practice Address - Street 1:8921 THREE CHOPT RD
Practice Address - Street 2:SUITE 300
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4601
Practice Address - Country:US
Practice Address - Phone:804-285-4585
Practice Address - Fax:804-285-7015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA028363OtherBC BS
VA028363OtherBC BS