Provider Demographics
NPI:1003804832
Name:RICHTER, PAUL ARTHUR (DPM)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ARTHUR
Last Name:RICHTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7926 W HILLSBOROUGH AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4600
Mailing Address - Country:US
Mailing Address - Phone:813-886-9180
Mailing Address - Fax:813-888-9093
Practice Address - Street 1:7926 W HILLSBOROUGH AVE
Practice Address - Street 2:SUITE G
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4600
Practice Address - Country:US
Practice Address - Phone:813-886-9180
Practice Address - Fax:813-888-9093
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1517213ES0131X
FLPO OOO1517213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104003200Medicaid
FL480002605OtherRAILROAD MEDICARE