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Individual

DR. MELVIN J. RICHARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
615 VALLEY VIEW DR., SUITE 202, MOLINE, IL 61265-6180
(309) 762-1072
(309) 762-1094
Mailing address
615 VALLEY VIEW DR., SUITE 202, MOLINE, IL 61265-6180
(309) 762-1072
(309) 762-1094

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036-045892
IL
2085R0202X
Diagnostic Radiology Physician
Primary
17497
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036045892
IL
05
0576694
IA
05
1576694
IA
01
20144
IA HEALTH SOLUTIONS
IA
05
2576694
IA
05
3576694
IA
01
47823
WELLMARK
IA
05
4916924
IA
05
5916924
IA
05
7916924
IA
05
8916924
IA
01
95101
WELLMARK
IL
01
97671
WELLMARK
IL
05
9916924
IA
Enumeration date
07/22/2005
Last updated
07/16/2010
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