# GARY S. RICHARDSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1700945045
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 073466 | MI | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 073466 | MI | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | 073466 | MI | Yes |

## Other

- **Enumeration date:** 12/06/2006
- **Last updated:** 09/24/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 411790510 | — | MI |
| 01 | — | 700H262220 | BLUE CROSS-BLUE CROSS | — |
| 01 | — | GR073466 | COMMERCIAL-COMMERCIAL NUMBER | — |