Organization
HAROLD RICHES D.O.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD RICHES D.O. (OWNER)
(414) 545-1120
Entity
Organization
Contact information
Practice address
9305 W NATIONAL AVE, WEST ALLIS, WI 53227-1541
(414) 545-1120
Mailing address
9305 W NATIONAL AVE, WEST ALLIS, WI 53227-1541
(414) 545-1120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21822
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30011000
—
WI
01
—
39130061011
BLUE CROSS
—
Enumeration date
07/22/2006
Last updated
10/01/2007
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