Doctor Name: | RALEIGH C. POWELL |
NPI Number: | 1003877416 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 0101019333 |
Business Practice Address: | 12 N Thompson St Richmond, VA - 232212718 |
Business Phone Number: | 8043591337 |
Business Fax Number: | 8043589861 |
Mailing Address: | Po Box 758963, BALTIMORE |
State: | MD |
Postal Code: | 212758963 |
Phone Number: | 8049685700 |
Fax Number: | 8042177991 |
NPI Enumeration Date: | 03/28/2006 |
NPI Last Update Date: | 10/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0101019333 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |