Provider Demographics
NPI:1710232558
Name:PARVIZI, DEREK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:
Last Name:PARVIZI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3813 GASKINS RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1436
Mailing Address - Country:US
Mailing Address - Phone:804-747-7787
Mailing Address - Fax:
Practice Address - Street 1:3813 GASKINS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1436
Practice Address - Country:US
Practice Address - Phone:804-747-7787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022117571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist