Provider Demographics
NPI:1396732426
Name:RICH, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:RICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2959 CANFIELD RD
Mailing Address - Street 2:SUITE 8 & 9
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-2800
Mailing Address - Country:US
Mailing Address - Phone:330-797-0222
Mailing Address - Fax:330-797-0058
Practice Address - Street 1:2959 CANFIELD RD
Practice Address - Street 2:SUITE 8 & 9
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44511-2800
Practice Address - Country:US
Practice Address - Phone:330-797-0222
Practice Address - Fax:330-797-0058
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35/05-9253R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0819985Medicaid
E67000Medicare UPIN
OH0819985Medicaid