Provider Demographics
NPI:1144263641
Name:RICHMAN, MARC N (MD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:N
Last Name:RICHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:148 LINDEN DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2818
Mailing Address - Country:US
Mailing Address - Phone:540-722-0627
Mailing Address - Fax:540-722-9533
Practice Address - Street 1:136 LINDEN DR
Practice Address - Street 2:SUITE 104
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2818
Practice Address - Country:US
Practice Address - Phone:540-678-3588
Practice Address - Fax:540-678-9025
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2012-09-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101234188208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010255449Medicaid
VA010255449Medicaid
H82000Medicare UPIN