Provider Demographics
NPI:1154399848
Name:HOPPMANN, RICHARD ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ANTHONY
Last Name:HOPPMANN
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:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:1801 SUNSET DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6803
Practice Address - Country:US
Practice Address - Phone:803-540-1000
Practice Address - Fax:803-540-1050
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD15089207RR0500X
SC15089207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTL2637Medicaid
C845777004Medicare ID - Type UnspecifiedTEACHING CLINIC
C845772603Medicare ID - Type Unspecified
SCTL2637Medicaid
C84577Medicare UPIN
SCC845777004Medicare PIN