Provider Demographics
NPI:1790741973
Name:FOHL, RICHARD BELL (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BELL
Last Name:FOHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5855 BREMO RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1926
Mailing Address - Country:US
Mailing Address - Phone:804-285-3019
Mailing Address - Fax:804-285-3021
Practice Address - Street 1:5855 BREMO RD
Practice Address - Street 2:SUITE 101
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1926
Practice Address - Country:US
Practice Address - Phone:804-285-3019
Practice Address - Fax:804-285-3021
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101-020564207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5962994Medicaid
072930755OtherPTAN
VAB59894Medicare UPIN
VA5962994Medicaid