Provider Demographics
NPI:1215900758
Name:ZUERNER, RICHARD TAYLOR (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:TAYLOR
Last Name:ZUERNER
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 1:38 POWEL AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2655
Mailing Address - Country:US
Mailing Address - Phone:401-847-2418
Mailing Address - Fax:401-619-1028
Practice Address - Street 1:38 POWEL AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-2655
Practice Address - Country:US
Practice Address - Phone:401-847-2418
Practice Address - Fax:401-619-1028
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD04393208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7001293Medicaid
RI007001293Medicare ID - Type Unspecified
RI7001293Medicaid