Provider Demographics
NPI:1265405393
Name:CURULLA, RICHARD MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:MICHAEL
Last Name:CURULLA
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 1:1925 GLENN MITCHELL DR STE 202
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-0177
Mailing Address - Country:US
Mailing Address - Phone:757-507-0900
Mailing Address - Fax:757-301-6462
Practice Address - Street 1:1925 GLENN MITCHELL DR STE 202
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-0177
Practice Address - Country:US
Practice Address - Phone:757-507-0900
Practice Address - Fax:757-301-6462
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101227511208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA541595397OtherPRIVATE HEALTHCARE SYSTEM
VA005873673Medicaid
VA541595397OtherVIRGINIA HEALTH NETWORK
VA541595397OtherMID ATLANTIC SOLUTION
VA7447132OtherAETNA
VA463312OtherANTHEM
VA541595397OtherTRICARE
VA541595397OtherCIGNA
VA27868OtherSENTARA/OPTIMA
VA7447132OtherAETNA
VA541595397OtherMID ATLANTIC SOLUTION