Individual
RICHARD COREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
620 BOULTON ST, BEL AIR, MD 21014-4255
(410) 836-7010
Mailing address
PO BOX 64481, BALTIMORE, MD 21264-4481
(410) 933-7475
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA1006
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091568800
—
MD
Enumeration date
01/13/2006
Last updated
01/31/2014
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