Healthcare Provider Details

I. General information

NPI: 1093750077
Provider Name (Legal Business Name): LEE DAVID RICHER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9767 N 91ST ST SUITE 101
SCOTTSDALE AZ
85258-5086
US

IV. Provider business mailing address

9767 N 91ST ST SUITE 101
SCOTTSDALE AZ
85258-5086
US

V. Phone/Fax

Practice location:
  • Phone: 480-629-5903
  • Fax:
Mailing address:
  • Phone: 480-629-5903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0544
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0544
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number0544
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: