Provider Demographics
NPI:1003817339
Name:ING, RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:ING
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 1:830 OLD LANCASTER RD
Mailing Address - Street 2:SUITE 306 MOB NORTH
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3118
Mailing Address - Country:US
Mailing Address - Phone:484-592-3000
Mailing Address - Fax:484-592-3009
Practice Address - Street 1:830 OLD LANCASTER RD
Practice Address - Street 2:SUITE 306 MOB NORTH
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3118
Practice Address - Country:US
Practice Address - Phone:484-592-3000
Practice Address - Fax:484-592-3009
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD067614L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F40902Medicare UPIN
NJ7875509Medicaid