Provider Demographics
NPI:1174500011
Name:STONE, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:STONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:14460 LAKESIDE CIR
Mailing Address - Street 2:STE 100
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-1348
Mailing Address - Country:US
Mailing Address - Phone:586-685-3285
Mailing Address - Fax:586-685-3286
Practice Address - Street 1:14460 LAKESIDE CIR
Practice Address - Street 2:STE 100
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1348
Practice Address - Country:US
Practice Address - Phone:586-685-3285
Practice Address - Fax:586-685-3286
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-30
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301039621207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OE060611071Medicare ID - Type Unspecified
A79949Medicare UPIN