Provider Demographics
NPI:1306842778
Name:NOBLE, RICHARD J (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:NOBLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 KATHSWAY CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-1449
Mailing Address - Country:US
Mailing Address - Phone:410-661-2132
Mailing Address - Fax:410-882-9222
Practice Address - Street 1:11 KATHSWAY CT
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-1449
Practice Address - Country:US
Practice Address - Phone:410-661-2132
Practice Address - Fax:410-882-9222
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD981213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT266Medicare PIN