Provider Demographics
NPI:1811989023
Name:RICHARDS, CYNTHIA G (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:G
Last Name:RICHARDS
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 1:8298 SEMINOLE TRL
Mailing Address - Street 2:
Mailing Address - City:RUCKERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22968-3492
Mailing Address - Country:US
Mailing Address - Phone:434-215-0772
Mailing Address - Fax:434-277-2778
Practice Address - Street 1:8298 SEMINOLE TRL
Practice Address - Street 2:
Practice Address - City:RUCKERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22968-3492
Practice Address - Country:US
Practice Address - Phone:434-215-0772
Practice Address - Fax:434-277-2778
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246018207Q00000X, 208M00000X
VAVA-0101246018207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA021997M54Medicare PIN
H28412Medicare UPIN
VAP01107051Medicare PIN