Provider Demographics
NPI:1912390816
Name:RICHARD B ABRISS MD PC
Entity Type:Organization
Organization Name:RICHARD B ABRISS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:ABRISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-270-3388
Mailing Address - Street 1:984 FIRST COLONIAL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3196
Mailing Address - Country:US
Mailing Address - Phone:757-270-3388
Mailing Address - Fax:757-481-6946
Practice Address - Street 1:984 FIRST COLONIAL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3196
Practice Address - Country:US
Practice Address - Phone:757-270-3388
Practice Address - Fax:757-481-6946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042057174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty