Provider Demographics
NPI:1154321321
Name:POMERANTZ, RICHARD WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WILLIAM
Last Name:POMERANTZ
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 1:2386 SPRINGS RD NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3066
Mailing Address - Country:US
Mailing Address - Phone:828-732-5400
Mailing Address - Fax:828-732-5401
Practice Address - Street 1:2386 SPRINGS RD NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3066
Practice Address - Country:US
Practice Address - Phone:828-732-5400
Practice Address - Fax:828-732-5401
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-00665207RP1001X, 207RC0200X
NC28207-1106207RP1001X
FLME77899207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCN0066HMedicaid
NC5912406Medicaid
NC5912406Medicaid
46388Medicare ID - Type Unspecified
SCN0066HMedicaid