Individual
DR. CHARLES DAVID RICHARDSON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2084P0005X
Neurodevelopmental Disabilities Physician
Primary
24662
MS
2084P0800X
Psychiatry Physician
24662
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24662
MEDICAL LICENSE
MS
Enumeration date
06/30/2013
Last updated
02/24/2025
Update your record
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