Provider Demographics
NPI:1558404954
Name:RICHTER, BRAD ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:BRAD
Middle Name:ARTHUR
Last Name:RICHTER
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 1:76 PEACHTREE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3131
Mailing Address - Country:US
Mailing Address - Phone:828-254-1969
Mailing Address - Fax:828-254-4611
Practice Address - Street 1:1781 METROMEDICAL DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3862
Practice Address - Country:US
Practice Address - Phone:828-254-1969
Practice Address - Fax:828-254-4611
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000955207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89127FKMedicaid
NC2281103Medicare ID - Type Unspecified