Provider Demographics
NPI:1508828401
Name:OHNMACHT, RICHARD K (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:K
Last Name:OHNMACHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:994 RESERVOIR AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-5122
Mailing Address - Country:US
Mailing Address - Phone:401-946-1944
Mailing Address - Fax:401-946-2340
Practice Address - Street 1:1145 RESERVOIR AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6055
Practice Address - Country:US
Practice Address - Phone:401-946-1944
Practice Address - Fax:401-946-2340
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI7462208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIF19807Medicare UPIN