Provider Demographics
NPI:1609927441
Name:RICHMAN, BRUCE DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:DAVID
Last Name:RICHMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 S WEST END BLVD
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1139
Mailing Address - Country:US
Mailing Address - Phone:215-257-1736
Mailing Address - Fax:215-257-2380
Practice Address - Street 1:30 S WEST END BLVD
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1139
Practice Address - Country:US
Practice Address - Phone:215-257-1736
Practice Address - Fax:215-257-2380
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006501L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS006501LOtherSTATE LICENSE
PA0011841450005Medicaid
PA0011841450005Medicaid
573026Medicare ID - Type Unspecified
PAOS006501LOtherSTATE LICENSE