Individual
DR. MARCIA JS RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
675 PARK CIR, ELM GROVE, WI 53122-2556
(262) 827-9888
(262) 827-9889
Mailing address
675 PARK CIR, ELM GROVE, WI 53122-2556
(262) 827-9888
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
17780
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17780
WISCONSIN MEDICAL LICENSE
WI
01
—
AR7369069
BNDD NUMBER
WI
Enumeration date
11/20/2008
Last updated
11/20/2008
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