Provider Demographics
NPI:1861435885
Name:RICHMAND, DAVID M (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:RICHMAND
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 1:1511 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5516
Mailing Address - Country:US
Mailing Address - Phone:908-561-9500
Mailing Address - Fax:908-561-7162
Practice Address - Street 1:1511 PARK AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5516
Practice Address - Country:US
Practice Address - Phone:908-561-9500
Practice Address - Fax:908-561-7162
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA040344002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2119740OtherAETNA
NJ0918232OtherCIGNA
NJ0141777000OtherAMERIHEALTH
NJ359183OtherUNITED HEALTHCARE
NJLS120OtherOXFORD
NJC58889Medicare UPIN
NJ165954MLAMedicare PIN