Provider Demographics
NPI:1275581605
Name:RICHARDS, STEVEN D (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:RICHARDS
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:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0449
Mailing Address - Country:US
Mailing Address - Phone:740-374-4500
Mailing Address - Fax:740-374-5887
Practice Address - Street 1:805 FARSON ST.
Practice Address - Street 2:SUITE 112
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714
Practice Address - Country:US
Practice Address - Phone:740-423-3202
Practice Address - Fax:740-423-3212
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20741207Q00000X
OH35.121433207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2321213Medicaid
WV1840762000Medicaid
OHP01279641OtherRAILROAD MEDICARE MHCPI
001722068OtherBLUE CROSS/BLUE SHIELD
080184029OtherRAILROAD MEDICARE
080184029OtherRAILROAD MEDICARE
001722068OtherBLUE CROSS/BLUE SHIELD
OHH204211 MMHMedicare PIN
OH2321213Medicaid