Provider Demographics
NPI:1538251715
Name:CAESAR, RICHARD EVAN (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:EVAN
Last Name:CAESAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BEVERLY RD
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2622
Mailing Address - Country:US
Mailing Address - Phone:207-949-7081
Mailing Address - Fax:
Practice Address - Street 1:50 ROWE ST STE 200
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3231
Practice Address - Country:US
Practice Address - Phone:781-620-4944
Practice Address - Fax:781-979-3433
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59487208800000X
IN01083147A208800000X
FLME1340542088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1900003OtherUNITED HEALTH
MA3069401Medicaid
MAJ09222OtherBC/MA
MAJ09222OtherBC/MA
E30001Medicare UPIN
MAPX6306Medicare PIN