Provider Demographics
NPI:1821253535
Name:BALL, CHUCK L (MD)
Entity Type:Individual
Prefix:
First Name:CHUCK
Middle Name:L
Last Name:BALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3900 WESTERRE PKWY
Mailing Address - Street 2:STE 300
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1339
Mailing Address - Country:US
Mailing Address - Phone:804-521-5315
Mailing Address - Fax:804-477-1252
Practice Address - Street 1:3900 WESTERRE PKWY STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1339
Practice Address - Country:US
Practice Address - Phone:804-521-5315
Practice Address - Fax:804-477-1252
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101250915207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV4469OtherMEDICARE
VA1821253535Medicaid
TNVAD000OtherFEDERAL UPIN