Provider Demographics
NPI:1376649046
Name:RICHTER, DONALD RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:RAY
Last Name:RICHTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:24 N WALNUT ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-4738
Mailing Address - Country:US
Mailing Address - Phone:301-745-3777
Mailing Address - Fax:301-393-3434
Practice Address - Street 1:24 N WALNUT ST
Practice Address - Street 2:SUITE 102
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4738
Practice Address - Country:US
Practice Address - Phone:301-745-3777
Practice Address - Fax:301-393-3434
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0030035207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD370281200Medicaid
WV0057265000Medicaid
MD370281200Medicaid
D75292Medicare UPIN
WV0057265000Medicaid