Provider Demographics
NPI:1982702551
Name:GUZZARDI, RICHARD WOODS (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WOODS
Last Name:GUZZARDI
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 1:724 CHERRYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-2757
Mailing Address - Country:US
Mailing Address - Phone:540-387-4090
Mailing Address - Fax:
Practice Address - Street 1:200 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:LURAY
Practice Address - State:VA
Practice Address - Zip Code:22835-1000
Practice Address - Country:US
Practice Address - Phone:540-743-4561
Practice Address - Fax:540-743-9560
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101050144207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1982702551Medicaid
VA013027L29Medicare PIN
009948P31Medicare ID - Type Unspecified
F88898Medicare UPIN