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Individual
MR. RICHARD A RICHARDSON
Active
Individual
MR. RICHARD A RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
22449
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018XV
BCBS GRP #
NC
01
—
193821
MEDCOST
NC
05
—
5902838
—
NC
Enumeration date
10/21/2005
Last updated
04/30/2018
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