Individual
GARY MICHAEL RICHARD
Active
Individual
GARY MICHAEL RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
029293
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000505414C
—
GA
01
—
10065573
AMERIGROUP
GA
05
—
G29293
—
SC
01
—
P00267043
RAILROAD MEDICARE
GA
Enumeration date
04/27/2006
Last updated
01/15/2020
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