Individual
DR. LARS CARVER RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 BEACON STREET, SUITE 5W, BROOKLINE, MA 02446
(617) 232-2663
(617) 232-6342
Mailing address
1101 BEACON STREET, SUITE 5W, BROOKLINE, MA 02446
(617) 232-2663
(617) 232-6342
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
204502
MA
207X00000X
Orthopaedic Surgery Physician
Primary
204502
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
172792
HARVARD PILGRIM
MA
01
—
204502
TUFTS
MA
05
—
3206629
—
MA
01
—
380493
HEALTH SOURCE
MA
01
—
5523775002
CIGNA
MA
01
—
7585085
AETNA
MA
01
—
J22212
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
07/26/2006
Last updated
03/18/2009
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