Provider Demographics
NPI:1811082126
Name:HUBERMAN, RICHARD ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALLEN
Last Name:HUBERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:701 DOCTORS DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1584
Mailing Address - Country:US
Mailing Address - Phone:252-522-2020
Mailing Address - Fax:252-527-7133
Practice Address - Street 1:701 DOCTORS DR
Practice Address - Street 2:SUITE G
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1584
Practice Address - Country:US
Practice Address - Phone:252-522-2020
Practice Address - Fax:252-527-7133
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC18526207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0468350001OtherMEDICARE DME
NC8944433Medicaid
NC44433OtherBCBS PROVIDER NUMBER
NC8944433Medicaid
NC0468350001OtherMEDICARE DME