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Individual

DR. RICHARD A LACAVERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
7B PITT ST, CHARLESTON, SC 29401
(843) 723-6166
(843) 534-2980
Mailing address
PO BOX 20430, CHARLESTON, SC 29413-0430
(843) 723-6166
(843) 534-2980

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0509
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005096
SC
01
080145984
RAILROAD MEDICARE
Enumeration date
08/29/2006
Last updated
05/06/2010
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