Provider Demographics
NPI:1124016001
Name:LITTLE, RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:LITTLE
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 1:6080 FALLS RD
Mailing Address - Street 2:STE 203
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2230
Mailing Address - Country:US
Mailing Address - Phone:410-377-8900
Mailing Address - Fax:410-377-4955
Practice Address - Street 1:6080 FALLS RD
Practice Address - Street 2:STE 203
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2230
Practice Address - Country:US
Practice Address - Phone:410-377-8900
Practice Address - Fax:410-377-4955
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD 18387207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
D 76760Medicare UPIN
MDH 726Medicare ID - Type Unspecified