Provider Demographics
NPI:1538112305
Name:ASARCH, RICHARD G (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
Last Name:ASARCH
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 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:3701 S CLARKSON ST STE 400
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3960
Practice Address - Country:US
Practice Address - Phone:303-761-7797
Practice Address - Fax:303-789-2995
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0018740207NS0135X, 207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCH9249OtherRAILROAD MEDICARE
COCH9249OtherRAILROAD MEDICARE
COL9318Medicare PIN
COL9318Medicare ID - Type Unspecified