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Individual

DUSTIN JON RICHTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2300 WESTERN AVE, MANITOWOC, WI 54220-3712
(920) 320-2011
Mailing address
1650 S 41ST ST, MANITOWOC, WI 54220-7316
(920) 320-2436

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD2024-0321
NM
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
74081-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
NM
390200000X
Student in an Organized Health Care Education/Training Program
WI

Other

Enumeration date
03/25/2019
Last updated
09/23/2025
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