Provider Demographics
NPI:1578565297
Name:WARNER, RICHARD S (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:S
Last Name:WARNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:191 LOWER ST
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01370-9402
Mailing Address - Country:US
Mailing Address - Phone:413-625-9300
Mailing Address - Fax:413-625-6007
Practice Address - Street 1:191 LOWER ST
Practice Address - Street 2:
Practice Address - City:SHELBURNE FALLS
Practice Address - State:MA
Practice Address - Zip Code:01370-9402
Practice Address - Country:US
Practice Address - Phone:413-625-9300
Practice Address - Fax:413-625-6007
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA44681207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine