Provider Demographics
NPI:1861668980
Name:CARD, RICHARD DEAN II (DO)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:DEAN
Last Name:CARD
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:VA
Mailing Address - Zip Code:24301-5087
Mailing Address - Country:US
Mailing Address - Phone:703-475-7633
Mailing Address - Fax:540-440-8924
Practice Address - Street 1:141 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:VA
Practice Address - Zip Code:24301-5087
Practice Address - Country:US
Practice Address - Phone:540-509-5443
Practice Address - Fax:540-440-8924
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102202489207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVM023AMedicare PIN