Provider Demographics
NPI:1033179148
Name:SZAGESH, RICHARD BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BRIAN
Last Name:SZAGESH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 ASHMAN ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4407
Mailing Address - Country:US
Mailing Address - Phone:989-835-2200
Mailing Address - Fax:
Practice Address - Street 1:2706 ASHMAN ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4407
Practice Address - Country:US
Practice Address - Phone:989-835-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23010007997111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4168397Medicaid
MI4168397Medicaid
MIU78429Medicare UPIN