Provider Demographics
NPI:1609947746
Name:NEMETH, RICHARD DESIDER (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DESIDER
Last Name:NEMETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 17334
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-1334
Mailing Address - Country:US
Mailing Address - Phone:703-443-6717
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:901 N PITT ST
Practice Address - Street 2:SUITE 150
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1536
Practice Address - Country:US
Practice Address - Phone:703-317-9500
Practice Address - Fax:703-317-4900
Is Sole Proprietor?:No
Enumeration Date:2006-11-12
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101058037207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1609947746Medicaid
VAG01815Medicare PIN
VA1609947746Medicaid
VAG01815R01Medicare PIN
DC233127ZBTPMedicare PIN