MEDICARE: DR. MILTON WALDO RICHARDSON DPM

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	213E00000X	Podiatrist	NC308	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	561982020	OTHER	ALL OTHER COMMERCIAL PAYO
2	5333086	OTHER	AETNA
3	10920106	OTHER	CIGNA
4	26929	OTHER	WELLPATH
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	0814N	OTHER	BCBS
7	2752571	OTHER	UNITED
8	81278	OTHER	MEDCOST

General Provider Information

NPI Number	:	1467413419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MILTON WALDO RICHARDSON DPM

Provider Business Mailing Address
First Line	:	1031 W WILLIAMS ST
Second Line	:	#105
City	:	APEX
State	:	NC
Zip	:	27502-3955
Country	:	US
Telephone Number	:	919-363-3310
Fax Number	:	919-363-3370

Provider Business Practice Location Address
First Line	:	1031 W WILLIAMS ST
Second Line	:	#105
City	:	APEX
State	:	NC
Zip	:	27502-3955
Country	:	US
Telephone Number	:	919-363-3310
Fax Number	:	919-363-3370

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

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	07/10/2008

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Directions to “ DR. MILTON WALDO RICHARDSON DPM” Practice Location

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