Individual
DANIEL DALE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
615 E 12TH ST, WASHINGTON, NC 27889-3408
(252) 946-0181
(252) 946-7774
Mailing address
615 E 12TH ST, WASHINGTON, NC 27889-3408
(252) 946-0181
(252) 946-7774
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036263
GA
208600000X
Surgery Physician
Primary
9600700
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2223843B
AETNA
NC
01
—
7908120
AETNA
NC
01
—
P00322237
RAILROAD MEDICARE
NC
Enumeration date
06/02/2006
Last updated
11/02/2012
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