Provider Demographics
NPI:1962407510
Name:PASCHOLD, JOHN C (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:PASCHOLD
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 1:500 SENTARA CIRCLE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-5727
Mailing Address - Country:US
Mailing Address - Phone:757-229-2236
Mailing Address - Fax:757-221-0409
Practice Address - Street 1:500 SENTARA CIRCLE
Practice Address - Street 2:SUITE 203
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5727
Practice Address - Country:US
Practice Address - Phone:757-229-2236
Practice Address - Fax:757-221-0409
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101059022174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00016047OtherRAILROAD MEDICARE
VA65593OtherOPTIMA
VA001233V63Medicare PIN
VAH52227Medicare UPIN
VA001866V25Medicare PIN