Individual
RICHARD A SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 569-0817
Mailing address
23100 PROVIDENCE DR, SOUTHFIELD, MI 48075-3646
(248) 569-0817
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301028753
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300F361310
BCBS OF MICHIGAN
MI
Enumeration date
07/24/2006
Last updated
06/13/2008
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