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General NPI Number Information
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NPI Number | 1306842414
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Entity Type | Individual
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Provider Name | LISA M RICHTER D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 55 BRENDON WAY STE 100
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City | ZIONSVILLE
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State | IN
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Zip | 46077-1955
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Country | US
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Telephone | 317-957-9150
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Fax | 317-957-9965
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Provider Business Mailing Address
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Address Line | 6626 E 75TH ST STE 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2805
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Country | US
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Telephone | 317-621-7584
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Fax | 317-957-2705
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02002515A
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License Number State | IN
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