Individual
IAN RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
302 S ROUTE 4 STE 207, CHALAN PAGO, GU 96910
(671) 477-2873
Mailing address
PO BOX 6065, MERIZO, GU 96916-0365
(671) 687-9800
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
204668
NY
207Q00000X
Family Medicine Physician
Primary
M1238
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02349686
—
NY
Enumeration date
10/02/2006
Last updated
05/01/2026
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