MEDICARE: KENNETH ALLEN RICHMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	MD016633E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RI086184	OTHER	PA	PA BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366449886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH ALLEN RICHMAN MD

Provider Business Mailing Address
First Line	:	51 NORTH 39TH STREET
Second Line	:	2ND FL. WRIGHT/SAUNDERS W223
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2640
Country	:	US
Telephone Number	:	215-662-8244
Fax Number	:	215-545-1543

Provider Business Practice Location Address
First Line	:	51 NORTH 39TH STREET
Second Line	:	2ND FL. WRIGHT/SAUNDERS W223
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2640
Country	:	US
Telephone Number	:	215-662-8244
Fax Number	:	215-545-1543

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	09/28/2012

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