Provider Demographics
NPI:1417162587
Name:MARGOLIS, RICHARD CRAIG (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CRAIG
Last Name:MARGOLIS
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 1:542 ROCK GLEN DR
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2621
Mailing Address - Country:US
Mailing Address - Phone:610-649-6016
Mailing Address - Fax:
Practice Address - Street 1:300 E LANCASTER AVE STE 207
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-2142
Practice Address - Country:US
Practice Address - Phone:610-649-6016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-041265L2084P0804X
DEC1-00037642084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry