Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 35075378 | OH |
Y | 207Q00000X | Family Doctor | 15792 | WV |
N | 207Q00000X | Family Doctor | 35075378 | OH |
NPI | 1003811472 |
---|---|
Provider Name | Richard Edward Cain |
First Address | Grantsville, WV 26147-7100 |
Second Address | Grantsville, WV 26147-7100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 04/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000228470 | ANTHEM (01) | OH |
000000699779 | ANTHEM (01) | OH |
0042198000 | (05) | WV |
0957166 | (05) | OH |
F05899 | (02) |