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Individual

BRIAN G RICHARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 N JEFFERSON ST, LEWISBURG, WV 24901
(304) 645-3220
(304) 645-4103
Mailing address
400 N JEFFERSON ST, LEWISBURG, WV 24901
(304) 645-3220
(304) 645-4103

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
12334
WV
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
12334
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0083419000
WV
01
110240176
RR/MEDICARE
WV
01
236228
ANTHEM
WV
01
540913938
CARELINK
WV
01
752887493002
TRICARE
WV
Enumeration date
06/16/2005
Last updated
05/13/2009
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