Provider Demographics
NPI:1578694162
Name:RICHMAN, EDWARD G (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:G
Last Name:RICHMAN
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 1:2616 LONGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3704
Mailing Address - Country:US
Mailing Address - Phone:302-475-8860
Mailing Address - Fax:302-475-1648
Practice Address - Street 1:2500 GRUBB RD
Practice Address - Street 2:BRANDYWOOD PLAZA, SUITE 110
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4799
Practice Address - Country:US
Practice Address - Phone:302-475-8860
Practice Address - Fax:302-475-1648
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0003891207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000423601Medicaid
DE727665Medicare ID - Type Unspecified
A14284Medicare UPIN