Provider Demographics
NPI:1831124247
Name:RICHMAN, BRIAN H (DPM PC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:H
Last Name:RICHMAN
Suffix:
Gender:M
Credentials:DPM PC
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Mailing Address - Street 1:1660 WEST ANTELOPE DRIVE
Mailing Address - Street 2:STE 110
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041
Mailing Address - Country:US
Mailing Address - Phone:801-825-4709
Mailing Address - Fax:801-774-0735
Practice Address - Street 1:1660 WEST ANTELOPE DRIVE
Practice Address - Street 2:STE 110
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041
Practice Address - Country:US
Practice Address - Phone:801-825-4709
Practice Address - Fax:801-774-0735
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT1066500501213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT0000200882OtherALTIUS
UT663556OtherHTH WORLDWIDE UNICARE
UT0000200881OtherALTIUS
UT107007424101OtherSELECT HEALTH IHC
UT522988354001OtherBLUE CROSS BLUE SHIELD
UT87067388184041A001OtherTRICARE
UT234764OtherDESERT MUTUAL
U36662Medicare UPIN