MEDICARE: CODY RICHARDSON 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	207WX0110X	Pediatric Ophthalmology and Strabismus Specialist Physician Physician	D0087052	MD

General Provider Information

NPI Number	:	1689086811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CODY RICHARDSON MD

Provider Business Mailing Address
First Line	:	6201 GREENLEIGH AVE
Second Line	:
City	:	MIDDLE RIVER
State	:	MD
Zip	:	21220-2004
Country	:	US
Telephone Number	:	410-955-8314
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N WOLFE ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21287-0005
Country	:	US
Telephone Number	:	410-955-8314
Fax Number	:	410-955-0809

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

Provider Enumeration Date	:	05/22/2014
Last Update Date	:	01/12/2026

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