Provider Demographics
NPI:1003811472
Name:CAIN, RICHARD EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:EDWARD
Last Name:CAIN
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 1:1212 GARFIELD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3247
Mailing Address - Country:US
Mailing Address - Phone:304-865-3655
Mailing Address - Fax:304-865-3700
Practice Address - Street 1:407 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1615
Practice Address - Country:US
Practice Address - Phone:740-315-5706
Practice Address - Fax:740-388-1665
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV15792207Q00000X, 207Q00000X
OH35075378207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0042198000Medicaid
OH000000228470OtherANTHEM
OH000000699779OtherANTHEM
OH0957166Medicaid
0751035Medicare ID - Type Unspecified
WV0042198000Medicaid
OH0957166Medicaid
OH000000228470OtherANTHEM