Provider Demographics
NPI:1558881532
Name:RICHARD, BARRETT (MD)
Entity Type:Individual
Prefix:
First Name:BARRETT
Middle Name:
Last Name:RICHARD
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 1:3970 PERKIOMEN AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-2757
Mailing Address - Country:US
Mailing Address - Phone:670-779-1330
Mailing Address - Fax:610-779-7699
Practice Address - Street 1:3970 PERKIOMEN AVE STE 202
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-2757
Practice Address - Country:US
Practice Address - Phone:670-779-1330
Practice Address - Fax:610-779-7699
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD473460207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine