Provider Demographics
NPI:1154624989
Name:SZADAJ, DAVID (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:SZADAJ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9480 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-5330
Mailing Address - Country:US
Mailing Address - Phone:804-270-1816
Mailing Address - Fax:804-270-2793
Practice Address - Street 1:9480 W BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-5330
Practice Address - Country:US
Practice Address - Phone:804-270-1816
Practice Address - Fax:804-270-2793
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011584183500000X
GARPH025624183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist