Elisabeth G. Richard, MD PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

D0062684 Issued in MD

Legal business name

ELISABETH G. RICHARD, MD PA

Practice address

10753 Falls Rd
Suite 355, Pavilion II
Lutherville, MD 21093-4535

Phone

(410) 847-3700

Fax

(410) 847-3703

NPI assigned

May 12, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elisabeth G. Richard, M.D.NPI 1932154093

Title

Physician, Director, President

Phone

(410) 847-3700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elisabeth G Richard, M.D.

  • Dermatology Physician
  • Lutherville, MD
  • NPI 1932154093
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1851779730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10753 FALLS RD",
            "address_2": "SUITE 355, PAVILION II",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934535",
            "telephone_number": "410-847-3700",
            "fax_number": "410-847-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10753 FALLS RD",
            "address_2": "SUITE 355, PAVILION II",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934535",
            "telephone_number": "410-847-3700",
            "fax_number": "410-847-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELISABETH G. RICHARD, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-12",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "RICHARD",
        "authorized_official_first_name": "ELISABETH",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PHYSICIAN, DIRECTOR, PRESIDENT",
        "authorized_official_telephone_number": "410-847-3700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0062684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.