Provider Demographics
NPI:1477504686
Name:COUNCELL, RICHARD BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BRUCE
Last Name:COUNCELL
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 1:2 YORKSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2752
Mailing Address - Country:US
Mailing Address - Phone:828-252-1050
Mailing Address - Fax:828-253-0457
Practice Address - Street 1:2 YORKSHIRE ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2752
Practice Address - Country:US
Practice Address - Phone:828-252-1050
Practice Address - Fax:828-253-0457
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33222207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC24679OtherBLUE CROSS
NC8924679Medicaid
NC07-70035OtherUNITED HEALTHCARE
NC07-70035OtherUNITED HEALTHCARE
B42023Medicare UPIN