1366434227 NPI number — DR. LAUREN B. RICHTER D.O.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366434227 NPI number — DR. LAUREN B. RICHTER D.O.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

RICHTER

Provider First Name:

LAUREN

Provider Middle Name:

B.

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

D.O.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1366434227

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/29/2008

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

29 S PACA ST

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

BALTIMORE

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

21201-1771

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

410-448-6772

Provider Business Mailing Address Fax Number:

410-448-1873

Provider First Line Business Practice Location Address:

2200 KERNAN DR

Provider Second Line Business Practice Location Address:

SECOND FLOOR

Provider Business Practice Location Address City Name:

BALTIMORE

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

21207-6665

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

410-448-6361

Provider Business Practice Location Address Fax Number:

410-448-1873

Provider Enumeration Date:

08/17/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207Q00000X , with the licence number:  O0036547 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 8110692 . This is a "MAMSI PRIMARY CARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 026151 . This is a "JHHC PROVIDER NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 4201552 . This is a "AETNA FEE FOR SERVICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 2313913 . This is a "AETNA CAPITATED" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 646861600 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 1180123 . This is a "CIGNA PIN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: P14862 . This is a "CAREFIRST MPOS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 080171386 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 2110692 . This is a "MAMSI SPECIALIST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 7605-0047 . This is a "CAREFIRST BLUECHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 529272-07 . This is a "CAREFIRST MD RENDERING" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".