Provider Demographics
NPI:1154475697
Name:RICHMAN, SANFORD N (MD)
Entity Type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:N
Last Name:RICHMAN
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 1:11500 OLD GEORGETOWN RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2735
Mailing Address - Country:US
Mailing Address - Phone:301-468-7788
Mailing Address - Fax:301-468-1188
Practice Address - Street 1:11500 OLD GEORGETOWN RD
Practice Address - Street 2:SUITE 3
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-2735
Practice Address - Country:US
Practice Address - Phone:301-468-7788
Practice Address - Fax:301-468-1188
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00011946207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD970081100Medicaid
4198147054OtherBC MD
328061OtherUNITED
C122OtherBCBS NCA
C122OtherBCBS NCA
MD970081100Medicaid