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Individual

MARK H RICHTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8355 HIGHLAND RD #106, WHITE LK, MI 48386
(248) 666-6005
(248) 666-6669
Mailing address
8355 HIGHLAND RD, WHITE LAKE, MI 48386-4618
(248) 666-6005
(248) 666-6669

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MR053494
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080186543
RR MEDICARE
01
080F32255
BCBS
01
0994309
HEALTH PLUS
01
383637981
TAX ID COMMERCIAL
01
4130452
AETHA
05
4408493
MI
Enumeration date
10/26/2006
Last updated
02/12/2016
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