Provider Demographics
NPI:1013917186
Name:THURMAN, ALAN L (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:L
Last Name:THURMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8580 MAGELLAN PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-1149
Mailing Address - Country:US
Mailing Address - Phone:804-627-5462
Mailing Address - Fax:866-449-0896
Practice Address - Street 1:8200 MEADOWBRIDGE RD STE 301
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2337
Practice Address - Country:US
Practice Address - Phone:804-442-3750
Practice Address - Fax:804-559-8535
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042834207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA204994OtherBLUE SHIELD
VA1013917186Medicaid
VA114708OtherBLUE SHIELD
VA114228OtherBLUE SHIELD
VA232562OtherBLUE SHIELD
VA005821673Medicaid
VA234124OtherBLUE SHIELD
VA016219V01Medicare PIN
VA1013917186Medicaid
VA114708OtherBLUE SHIELD
VA015216V20Medicare PIN
VA015215V21Medicare PIN
VA015214V68Medicare PIN