Provider Demographics
NPI:1760410682
Name:RICH, DAN H (MD)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:H
Last Name:RICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6 PARTRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:BOXFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01921-1902
Mailing Address - Country:US
Mailing Address - Phone:978-463-1120
Mailing Address - Fax:978-463-1171
Practice Address - Street 1:25 HIGHLAND AVE
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3867
Practice Address - Country:US
Practice Address - Phone:978-463-1120
Practice Address - Fax:978-463-1171
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA0425422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0116866Medicaid
NH30008648Medicaid
NH30008648Medicaid
A43410Medicare UPIN