MEDICARE: DR. RICHARD EUGENE MINTER M.D.

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	174400000X	Specialist	35045691-M	OH

General Provider Information

NPI Number	:	1609947951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD EUGENE MINTER M.D.

Provider Business Mailing Address
First Line	:	2554 SONNINGTON DR
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-9242
Country	:	US
Telephone Number	:	614-764-2562
Fax Number	:	614-848-4916

Provider Business Practice Location Address
First Line	:	500 W WILSON BRIDGE RD STE 10
Second Line	:
City	:	WORTHINGTON
State	:	OH
Zip	:	43085-2238
Country	:	US
Telephone Number	:	614-848-4820
Fax Number	:	614-848-4916

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

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	10/04/2019

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