Healthcare Provider Details
I. General information
NPI: 1033214762
Provider Name (Legal Business Name): RICHARD CHARLES TUCHMAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/14/2006
Last Update Date: 07/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2706 ST JUDE ST THE TRIAD FOOT CENTER PA
GREENSBORO NC
27405
US
IV. Provider business mailing address
2706 SAINT JUDE ST THE TRIAD FOOT CENTER PA
GREENSBORO NC
27405-3670
US
V. Phone/Fax
- Phone: 336-375-6990
- Fax: 336-375-0361
- Phone: 336-375-6990
- Fax: 336-375-0361
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | 83 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: