Provider Demographics
NPI:1790770071
Name:MORIN, RICHARD ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:ARTHUR
Last Name:MORIN
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 1:1500 SOUTH 48TH STREET
Mailing Address - Street 2:SUITE 506
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506
Mailing Address - Country:US
Mailing Address - Phone:402-489-1110
Mailing Address - Fax:402-489-8492
Practice Address - Street 1:1500 SOUTH 48TH STREET
Practice Address - Street 2:SUITE 506
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516
Practice Address - Country:US
Practice Address - Phone:402-489-1110
Practice Address - Fax:402-489-8492
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16402207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47081642113Medicaid
D17324Medicare UPIN
NE47081642113Medicaid