Individual
MR. RICHARD J MAILLOUX
Active
Individual
MR. RICHARD J MAILLOUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
18094
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000691895
ANTHEM BCBS
KY
05
—
0088257000
—
WV
01
—
0151526
MEDICAID
OH
01
—
110103523
RAILROAD MEDICARE
—
05
—
64072697
—
KY
Enumeration date
06/06/2006
Last updated
09/18/2019
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