Provider Demographics
NPI:1316115439
Name:SIMMS, RICHARD ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ARTHUR
Last Name:SIMMS
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 1:7115 RAVENNA TRL
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-7827
Mailing Address - Country:US
Mailing Address - Phone:517-327-0906
Mailing Address - Fax:
Practice Address - Street 1:7115 RAVENNA TRL
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-7827
Practice Address - Country:US
Practice Address - Phone:517-327-0906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301037998207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE30345Medicare UPIN