Provider Demographics
NPI:1548252265
Name:CARUSO, RICHARD F (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:F
Last Name:CARUSO
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:PO BOX 472
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-0422
Mailing Address - Country:US
Mailing Address - Phone:302-645-6698
Mailing Address - Fax:302-645-4505
Practice Address - Street 1:1309 SAVANNAH RD
Practice Address - Street 2:STE B
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1514
Practice Address - Country:US
Practice Address - Phone:302-645-6698
Practice Address - Fax:302-645-4505
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0004112207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000494801Medicaid
F32579Medicare UPIN
DE0000494801Medicaid