Richard Logan Altizer, PHARMD
Individual provider Active NPI Pharmacist · Sterling, VA
NPI 1043797285 · NPPES record last updated Jul 20, 2018
Key facts
- NPI
- 1043797285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202216878 (VA)
- Practice address
- 22370 Davis Dr Ste 190
Sterling, VA 20164-5367 - Phone
- (703) 434-0698
- NPI assigned
- Jul 20, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202216878 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202216878 | VA | Yes |
Addresses
Primary practice location
22370 Davis Dr Ste 190
Sterling, VA 20164-5367
Mailing address
7480 Birdwood Ave
Apt #416
McLean, VA 22102
Phone (540) 309-7984
Other providers in Sterling, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.