Provider Demographics
NPI:1760459325
Name:STEVEN A RICHMAN MD LLC
Entity Type:Organization
Organization Name:STEVEN A RICHMAN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:RICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-436-6936
Mailing Address - Street 1:405 TALLMADGE RD
Mailing Address - Street 2:SUITE 127
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3342
Mailing Address - Country:US
Mailing Address - Phone:330-436-6936
Mailing Address - Fax:
Practice Address - Street 1:330 BROADWAY ST E
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3312
Practice Address - Country:US
Practice Address - Phone:330-496-0910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35075905207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2754765Medicaid
OH2754765Medicaid
OH9335961Medicare PIN