Individual
MR. RICHARD WESLEY MINIELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
63 OFFICE PARK DRIVE, ROANOKE RAPIDS, NC 27870
(252) 535-4343
(252) 308-0977
Mailing address
63 OFFICE PARK DRIVE, ROANOKE RAPIDS, NC 27870
(252) 535-4343
(252) 308-0977
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35991
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8959536
—
NC
Enumeration date
03/24/2006
Last updated
11/29/2011
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