Provider Demographics
NPI:1013006733
Name:LYNCH, RICHARD E (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:E
Last Name:LYNCH
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 1:4800 FRIENDSHIP AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1722
Mailing Address - Country:US
Mailing Address - Phone:412-578-5000
Mailing Address - Fax:412-578-4981
Practice Address - Street 1:804 SCOTT NIXON MEMORIAL DR
Practice Address - Street 2:ATTN: PROVIDER ENROLLMENT
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-2464
Practice Address - Country:US
Practice Address - Phone:800-394-4445
Practice Address - Fax:706-955-0735
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428837207L00000X
NY234955207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018666300001Medicaid
OH2767519Medicaid
WV3810009039Medicaid
WV3810009039Medicaid