Provider Demographics
NPI:1912346909
Name:SHISHIDO, AKIRA A (MD)
Entity type:Individual
Prefix:DR
First Name:AKIRA
Middle Name:A
Last Name:SHISHIDO
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 1:1000 E. MARSHALL STREET
Mailing Address - Street 2:PO BOX 980049
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0001
Mailing Address - Country:US
Mailing Address - Phone:631-655-1984
Mailing Address - Fax:
Practice Address - Street 1:1000 E. MARSHALL STREET
Practice Address - Street 2:PO BOX 980049
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0001
Practice Address - Country:US
Practice Address - Phone:631-655-1984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-23
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101257058207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine