Individual
JEFFREY MICHAEL RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2112 DUNDALK AVE, BALTIMORE, MD 21222-3714
(410) 288-4800
Mailing address
3100 WYMAN PARK DR, BALTIMORE, MD 21211-2803
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D36430
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285431700
—
MD
Enumeration date
06/12/2006
Last updated
05/09/2013
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