Waller, Richard Edmund
Waller, Richard Edmund is an individual health care provider with primary practice located at 14355 Sommerville Ct , Midlothian VA 23113. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Waller, Richard Edmund can be contacted via phone (804) 379-7721.Contact Information
Primary practice address
14355 Sommerville Ct
Midlothian VA 23113
Phone: (804) 379-7721
Fax: (804) 379-7699
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 0101040746 | Virginia |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 0101040746 | Virginia |
Profile Details
| NPI number | 1871541862 |
|---|---|
| LBN Legal business name | Waller, Richard Edmund |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Mar 24th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871541862 | NPPES |
| Virginia | MEDICAID | 010131855 |
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