| Doctor Name: | DR. DAVID RICHARD ANTONIO |
| NPI Number: | 1750374005 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 0101034363 |
| Business Practice Address: | 95 Harris Rd Building 5 Kilmarnock, VA - 224823845 |
| Business Phone Number: | 8044353146 |
| Business Fax Number: | 8044356054 |
| Mailing Address: | 1115 Boulders Pkwy, Suite 200 NORTH CHESTERFIELD |
| State: | VA |
| Postal Code: | 232254067 |
| Phone Number: | 8045605595 |
| Fax Number: | 8045609029 |
| NPI Enumeration Date: | 08/23/2005 |
| NPI Last Update Date: | 02/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 0101034363 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |