Provider Demographics
NPI:1013965037
Name:GARWOOD, RICHARD M (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:GARWOOD
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 1:4200 WARRENSVILLE CENTER RD
Mailing Address - Street 2:SUITE 395
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7051
Mailing Address - Country:US
Mailing Address - Phone:216-491-7888
Mailing Address - Fax:216-491-7887
Practice Address - Street 1:4200 WARRENSVILLE CENTER RD
Practice Address - Street 2:SUITE 395
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7051
Practice Address - Country:US
Practice Address - Phone:216-491-7888
Practice Address - Fax:216-491-7887
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.002655207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0155335Medicaid
OH0463618Medicare PIN
OH0155335Medicaid