Individual
BERNARD RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
740 W GREEN MEADOWS DR, SUITE 105, GREENFIELD, IN 46140-3098
(317) 318-7777
(317) 318-7700
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
(317) 318-7712
(317) 318-7700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01060462A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000377731
ANTHEM
IN
05
—
200531790
—
IN
01
—
P01014103
RR MEDICARE PTAN
IN
Enumeration date
07/28/2006
Last updated
11/27/2023
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