Provider Demographics
NPI:1457353013
Name:RICHMAN, ERIC T (DPM)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:T
Last Name:RICHMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 E MILLTOWN RD
Mailing Address - Street 2:STE B
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-1250
Mailing Address - Country:US
Mailing Address - Phone:330-345-8300
Mailing Address - Fax:330-345-6606
Practice Address - Street 1:470 E MILLTOWN RD
Practice Address - Street 2:STE B
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-1250
Practice Address - Country:US
Practice Address - Phone:330-345-8300
Practice Address - Fax:330-345-6606
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-1879-R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0366116Medicaid
OH4826060001Medicare NSC
OH0366116Medicaid