Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | OS016202 | PA |
NPI | 1205078581 |
---|---|
Provider Name | Nicholas Richardson |
First Address | Silver Spring, MD 20993-0002 |
Second Address | Silver Spring, MD 20993-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2009 |
Last Update Date | 02/11/2016 |