Provider Demographics
NPI:1699703363
Name:LIND, RICHARD A (DPM)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:LIND
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:10370 PARK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-8508
Mailing Address - Country:US
Mailing Address - Phone:704-542-8253
Mailing Address - Fax:704-541-0186
Practice Address - Street 1:717 S TORRENCE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2927
Practice Address - Country:US
Practice Address - Phone:704-334-8682
Practice Address - Fax:704-541-0186
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC482213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2430166Medicare ID - Type Unspecified
NCT92736Medicare UPIN