Provider Demographics
NPI:1578534905
Name:EANNI, RICHARD F (MD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:F
Last Name:EANNI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:17705 SPRINGWINDS DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-7744
Mailing Address - Country:US
Mailing Address - Phone:704-895-3415
Mailing Address - Fax:704-895-3416
Practice Address - Street 1:16511 A NORTHCROSS DR
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-5021
Practice Address - Country:US
Practice Address - Phone:704-896-3313
Practice Address - Fax:704-896-8193
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME32687207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL93637YMedicare ID - Type UnspecifiedMEDICARE