Provider Demographics
NPI:1891826756
Name:RICH, PETROVIA MORGAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PETROVIA
Middle Name:MORGAN
Last Name:RICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 MIDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23236-3444
Mailing Address - Country:US
Mailing Address - Phone:804-320-2274
Mailing Address - Fax:
Practice Address - Street 1:909 HIOAKS RD
Practice Address - Street 2:SUITE I
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4038
Practice Address - Country:US
Practice Address - Phone:804-330-7387
Practice Address - Fax:804-330-0908
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA0101038385207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000027291OtherBCBS ANTHEM
220021OtherMDIPA
220021OtherMDIPA