Provider Demographics
NPI:1528495744
Name:MARK J. RICHMAN, MD PC
Entity type:Organization
Organization Name:MARK J. RICHMAN, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:RICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-674-1222
Mailing Address - Street 1:3915 VETERANS MEMORIAL DR STE 106
Mailing Address - Street 2:
Mailing Address - City:ADAMSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35005-2273
Mailing Address - Country:US
Mailing Address - Phone:205-674-1222
Mailing Address - Fax:205-674-1230
Practice Address - Street 1:3915 VETERANS MEMORIAL DR STE 106
Practice Address - Street 2:
Practice Address - City:ADAMSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35005-2273
Practice Address - Country:US
Practice Address - Phone:205-674-1222
Practice Address - Fax:205-674-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty