Individual
DR. KENNETH J RICHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
34505 WEST 12 MILE RD SUITE 100, FARMINGTON HILLS, MI 48331
(734) 343-7500
(312) 957-9991
Mailing address
34505 WEST 12 MILE RD SUITE 100, FARMINGTON HILLS, MI 48331
(734) 343-7500
(312) 957-9991
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
5101007564
MI
208100000X
Physical Medicine & Rehabilitation Physician
5101007564
MI
2081P0004X
Spinal Cord Injury Medicine Physician
5101007564
MI
2081P0010X
Pediatric Rehabilitation Medicine Physician
5101007564
MI
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
5101007564
MI
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
5101007564
MI
208VP0000X
Pain Medicine Physician
5101007564
MI
208VP0014X
Interventional Pain Medicine Physician
5101007564
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2905041 TYPE 11
—
MI
Enumeration date
06/07/2006
Last updated
07/03/2019
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