Provider Demographics
NPI:1699898528
Name:VIRGIL, RICHARD ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALAN
Last Name:VIRGIL
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 1:8904 BURDETTE RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-2112
Mailing Address - Country:US
Mailing Address - Phone:301-767-0898
Mailing Address - Fax:301-767-0898
Practice Address - Street 1:5415 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE T-43
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2765
Practice Address - Country:US
Practice Address - Phone:202-237-8300
Practice Address - Fax:301-767-0898
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD119152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCB94401Medicare UPIN
DC197980Medicare ID - Type Unspecified