Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | DR.0018740 | CO |
N | 207ND0101X | MOHS-Micrographic Surgeon | DR.0018740 | CO |
N | 207NS0135X | Procedural Dermatology | DR.0018740 | CO |
NPI | 1538112305 |
---|---|
Provider Name | Dr. Richard G Asarch |
First Address | Manitowoc, WI 54220-4630 |
Second Address | Englewood, CO 80113-3960 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 12/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CH9249 | RAILROAD MEDICARE (01) | CO |
D23485 | (02) | CO |