Healthcare Provider Details

I. General information

NPI: 1306163043
Provider Name (Legal Business Name): RICHARD FREDERICK LIMOGES, MD, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 04/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 PINE ST ST. REGIS COURT, SUITE 1B
PHILADELPHIA PA
19107-6187
US

IV. Provider business mailing address

822 PINE ST ST. REGIS COURT, SUITE 1B
PHILADELPHIA PA
19107-6187
US

V. Phone/Fax

Practice location:
  • Phone: 215-546-6437
  • Fax: 215-627-5644
Mailing address:
  • Phone: 215-546-6437
  • Fax: 215-627-5644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberMD008109E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberMD008109E
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD008109E
License Number StatePA

VIII. Authorized Official

Name: DR. RICHARD FREDERICK LIMOGES
Title or Position: OWNER
Credential: M.D.
Phone: 215-546-6437