Provider Demographics
NPI:1093750077
Name:RICHER, LEE DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:DAVID
Last Name:RICHER
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 1:9767 N 91ST ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5086
Mailing Address - Country:US
Mailing Address - Phone:480-629-5903
Mailing Address - Fax:
Practice Address - Street 1:9767 N 91ST ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5086
Practice Address - Country:US
Practice Address - Phone:480-629-5903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0544213E00000X, 213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ593998004OtherMERCY CARE
AZ2Z1935OtherHEALTH NET
AZ7359309OtherAETNA
AZ593998Medicaid
AZAZ0195200OtherBLUE CROSS/BLUE SHIELD AZ
AZ7359309OtherAETNA
AZ593998Medicaid
AZP00260959Medicare PIN