Provider Demographics
NPI:1548283054
Name:SOLOMON, RICHARD KEITH (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:KEITH
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3541 W BRADDOCK RD STE 203
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1902
Mailing Address - Country:US
Mailing Address - Phone:703-379-4055
Mailing Address - Fax:703-379-1099
Practice Address - Street 1:3541 W BRADDOCK RD STE 203
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1902
Practice Address - Country:US
Practice Address - Phone:703-379-4055
Practice Address - Fax:703-379-1099
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU80482Medicare UPIN
VAG02236B01Medicare ID - Type Unspecified