MEDICARE: CRAIG ALAN RICHMAN 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	048710	GA
2	207YS0012X	Sleep Medicine (Otolaryngology) Physician	48710	GA
3	207Y00000X	Otolaryngology Physician	48710	GA

General Provider Information

NPI Number	:	1902806284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG ALAN RICHMAN M.D.

Provider Business Mailing Address
First Line	:	1474 VALLEY GLEN WAY
Second Line	:
City	:	DUNWOODY
State	:	GA
Zip	:	30338-5522
Country	:	US
Telephone Number	:	770-396-4668
Fax Number	:	770-396-4668

Provider Business Practice Location Address
First Line	:	1474 VALLEY GLEN WAY
Second Line	:
City	:	DUNWOODY
State	:	GA
Zip	:	30338-5522
Country	:	US
Telephone Number	:	404-990-1899
Fax Number	:	770-396-4668

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	04/23/2015

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