Individual
STANLEY D. RICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7916 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 432-2297
(260) 434-6433
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01026351A
IN
207RI0011X
Interventional Cardiology Physician
Primary
01026351A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000087414
ANTHEM
IN
05
—
0776576
—
OH
05
—
100096460
—
IN
01
—
P00783728
RAILROAD
IN
Enumeration date
01/25/2006
Last updated
09/29/2020
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