Healthcare Provider Details

I. General information

NPI: 1730152133
Provider Name (Legal Business Name): RICHTER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 02/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8355 HIGHLAND RD
WHITE LAKE MI
48386-4618
US

IV. Provider business mailing address

8355 HIGHLAND RD
WHITE LAKE MI
48386-4618
US

V. Phone/Fax

Practice location:
  • Phone: 248-666-6005
  • Fax: 248-666-6669
Mailing address:
  • Phone: 248-666-6005
  • Fax: 248-666-6669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMR053494
License Number StateMI

VIII. Authorized Official

Name: DR. MAEK H RICHTER
Title or Position: SECRETARY TREASURER
Credential: MD
Phone: 248-819-2414