Provider Demographics
NPI:1336191857
Name:ALARID, RICHARD RUPERT (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:RUPERT
Last Name:ALARID
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 1:4750 HEMPSTEAD STATION DR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5164
Mailing Address - Country:US
Mailing Address - Phone:800-875-0136
Mailing Address - Fax:937-619-4342
Practice Address - Street 1:11111 S 84TH ST
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4122
Practice Address - Country:US
Practice Address - Phone:402-593-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16176207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
01047OtherBCBS
NE100249951-00Medicaid
IA6982710Medicaid
1016OtherMIDLANDS CHOICE/MUT OMAHA
NE39-00186OtherSHAREADVANTAGE MEDICAID
IA3982710Medicaid
E41052Medicare UPIN
NE100249951-00Medicaid