Provider Demographics
NPI:1821099425
Name:RICH, CADMUS COLLINS (MD)
Entity Type:Individual
Prefix:
First Name:CADMUS
Middle Name:COLLINS
Last Name:RICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4102 N ROXBORO RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704
Mailing Address - Country:US
Mailing Address - Phone:919-595-2000
Mailing Address - Fax:919-595-2190
Practice Address - Street 1:4102 N ROXBORO ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2122
Practice Address - Country:US
Practice Address - Phone:919-595-2000
Practice Address - Fax:919-595-2190
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9601453207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5612887670OtherCIGNA
NC5556464OtherAETNA
NC0856311OtherUNITED HEALTHCARE
NC98509OtherMEDCOST
NC891028TMedicaid
NC1028TOtherBCBS NC
NC23356OtherOPTICARE
NC483533OtherMAMSI
NC5556464OtherAETNA
NC2281184Medicare ID - Type UnspecifiedCIGNA