Individual
DR. RICHARD W RISSMILLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200001266
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
200001266
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35449
SC
207RP1001X
Pulmonary Disease Physician
200001266
NC
207RP1001X
Pulmonary Disease Physician
Primary
35449
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138CW
NCBCBS
NC
05
—
89138CW
—
NC
05
—
N01269
—
SC
Enumeration date
07/13/2006
Last updated
06/19/2019
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