Individual
DR. MARK DAVID RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
215 E MANSION ST, SUITE 1E, MARSHALL, MI 49068-1559
(269) 781-3938
Mailing address
215 E MANSION ST, SUITE 1E, MARSHALL, MI 49068-1559
(269) 781-3938
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301047635
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2895802
—
MI
Enumeration date
03/01/2006
Last updated
03/15/2016
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