Provider Demographics
NPI:1922118934
Name:PATTERSON, RICHARD D JR (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:D
Last Name:PATTERSON
Suffix:JR
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 1:3605 WARRENSVILLE CENTER ROAD
Mailing Address - Street 2:MSC9152
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-286-6299
Mailing Address - Fax:216-286-6341
Practice Address - Street 1:11100 EUCLID AVENUE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-844-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0696762085R0202X
OH350696762085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH731514OtherBUCKEYE COMM HEALTH PLAN
OHCN1167OtherRRMC
OH000000221312OtherUNISON
OH2026202Medicaid
OH300084158OtherRAILROAD MEDICARE
OH751195OtherBUCKEYE
OHCF7408OtherRRMC
OH7384635OtherAETNA
OH0304914OtherBCMH
OHCC3678OtherRRMC
OH000000516405OtherANTHEM
OH000000025902OtherANTHEM BC/BS
OH363905OtherWELLCARE
OH0304914OtherBCMH
OH731514OtherBUCKEYE COMM HEALTH PLAN
OH300084158OtherRAILROAD MEDICARE
OH751195OtherBUCKEYE
OH2026202Medicaid
OHCN1167OtherRRMC
OH4048583Medicare PIN