Individual
DR. RICHARD OLIVER BIDO MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-5600
Mailing address
1308 GRANDVIEW DR APT 1, CHAMPAIGN, IL 61820-6845
(217) 954-8026
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1016368
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2019
Last updated
06/28/2023
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