Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | DC4217 | DC |
NPI | 1013080365 |
---|---|
Provider Name | Dr. Richard Martin Restak |
First Address | Washington, DC 20009-1625 |
Second Address | Washington, DC 20009-1625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |