Provider Demographics
NPI:1013080365
Name:RESTAK, RICHARD MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MARTIN
Last Name:RESTAK
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 1:1800 R ST NW
Mailing Address - Street 2:SUITE C-3
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-1625
Mailing Address - Country:US
Mailing Address - Phone:202-462-0455
Mailing Address - Fax:202-462-0340
Practice Address - Street 1:1800 R ST NW
Practice Address - Street 2:SUITE C-3
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1625
Practice Address - Country:US
Practice Address - Phone:202-462-0455
Practice Address - Fax:202-462-0340
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDC42172084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology