Provider Demographics
NPI:1649206640
Name:CASH, RICHARD (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:CASH
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 1:270 MAIN ST N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-6785
Mailing Address - Country:US
Mailing Address - Phone:651-242-1039
Mailing Address - Fax:855-264-1094
Practice Address - Street 1:270 MAIN ST N
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6785
Practice Address - Country:US
Practice Address - Phone:651-342-1039
Practice Address - Fax:855-264-1094
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43115207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN761180300Medicaid
MN761180300Medicaid
MNH34484Medicare UPIN