Individual
DR. THOMAS DAVID RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
32967
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0188789
—
IA
01
—
49599
BLUE CROSS/BLUE SHIELD
IA
Enumeration date
07/11/2005
Last updated
09/11/2013
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