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Individual

RICHARD M SHOUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
112 SPENCER ST, MANCHESTER, CT 06040-4601
(860) 432-5600
(860) 432-5622
Mailing address
71 HAYNES ST, MANCHESTER, CT 06040-4188
(860) 646-1222
(860) 432-5622

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
33290
CT
207RP1001X
Pulmonary Disease Physician
033290
CT
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
033290
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001332907
CT
Enumeration date
02/08/2006
Last updated
05/06/2026
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