Provider Demographics
NPI:1861468597
Name:WINGER, RICHARD W (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:W
Last Name:WINGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 OLD TROY PIKE
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-1066
Mailing Address - Country:US
Mailing Address - Phone:937-558-3300
Mailing Address - Fax:937-558-3308
Practice Address - Street 1:8701 OLD TROY PIKE
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-1066
Practice Address - Country:US
Practice Address - Phone:937-558-3300
Practice Address - Fax:937-558-3313
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-005798207P00000X
OH34.005798207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP01387676OtherRR MEDICARE
OH110094849OtherRR MCR
OH0985199Medicaid
OHH371870Medicare PIN
OHP01387676OtherRR MEDICARE
OHWI0748251Medicare PIN