Organization
MARK D RICHARDSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK DAVID RICHARDSON M.D. (OWNER)
(269) 781-3938
Entity
Organization
Contact information
Practice address
215 E MANSION ST STE 1E, MARSHALL, MI 49068-1167
(269) 781-3938
(269) 781-8364
Mailing address
215 E MANSION ST STE 1E, MARSHALL, MI 49068-1167
(269) 781-3938
(269) 781-8364
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
01/15/2009
Last updated
06/10/2010
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