Provider Demographics
NPI:1750909404
Name:RICHARD, CELINE (MD PHD)
Entity type:Individual
Prefix:MRS
First Name:CELINE
Middle Name:
Last Name:RICHARD
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PEDIATRIC ENT DEPARTMENT, NATIONWIDE CHILDREN'S HOSPITA
Mailing Address - Street 2:700 CHILDREN'S DR.
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205
Mailing Address - Country:US
Mailing Address - Phone:614-737-5744
Mailing Address - Fax:
Practice Address - Street 1:51 N DUNLAP ST # G10
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-4625
Practice Address - Country:US
Practice Address - Phone:901-287-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN65584207YP0228X
OH57.248750207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology