Provider Demographics
NPI:1538128574
Name:CORBIN, RICHARD PRESLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:PRESLEY
Last Name:CORBIN
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 1:55 DROMORE VIEW RD
Mailing Address - Street 2:PO BOX 338
Mailing Address - City:PHIPPSBURG
Mailing Address - State:ME
Mailing Address - Zip Code:04562-4444
Mailing Address - Country:US
Mailing Address - Phone:207-389-1574
Mailing Address - Fax:
Practice Address - Street 1:1 VA CTR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-6719
Practice Address - Country:US
Practice Address - Phone:207-623-8411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101019829207RC0200X
ME009851207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA055687Medicare ID - Type Unspecified
VAB86770Medicare UPIN