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General NPI Number Information
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NPI Number | 1306040621
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Entity Type | Organization
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Legal Business Name | RICHARD H HERSHEY MD INC
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 400 MATTHEW ST SUITE 202
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City | MARIETTA
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State | OH
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Zip | 45750
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Country | US
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Telephone | 740-374-3371
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Fax | 740-376-5599
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Provider Business Mailing Address
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Address Line | 400 MATTHEW ST SUITE 202
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City | MARIETTA
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State | OH
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Zip | 45750
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Country | US
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Telephone | 740-374-3371
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Fax | 740-376-5599
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD H HERSHEY
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Credential | MD
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Telephone | 740-574-3371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 36466
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License Number State | OH
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