Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 0544 | AZ |
N | 222Z00000X | Podiatrist | 0544 | AZ |
Y | 213ES0103X | Foot & Ankle Surgery | 0544 | AZ |
N | 213ES0131X | Foot Surgery | 0544 | AZ |
NPI | 1093750077 |
---|---|
Provider Name | Dr. Lee David Richer |
First Address | Scottsdale, AZ 85258-5086 |
Second Address | Scottsdale, AZ 85258-5086 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 02/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2Z1935 | HEALTH NET (01) | AZ |
593998 | (05) | AZ |
593998004 | MERCY CARE (01) | AZ |
7359309 | AETNA (01) | AZ |
AZ0195200 | BLUE CROSS/BLUE SHIELD AZ (01) | AZ |
U86189 | (02) | AZ |