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General NPI Number Information
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NPI Number | 1922022649
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Entity Type | Individual
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Provider Name | LARS CARVER RICHARDSON MD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 03/18/2009
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Provider Practice Location Address
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Address Line | 1101 BEACON STREET SUITE 5W
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City | BROOKLINE
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State | MA
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Zip | 02446
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Country | US
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Telephone | 617-232-2663
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Fax | 617-232-6342
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Provider Business Mailing Address
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Address Line | 1101 BEACON STREET SUITE 5W
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City | BROOKLINE
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State | MA
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Zip | 02446
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Country | US
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Telephone | 617-232-2663
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Fax | 617-232-6342
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 204502
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 204502
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License Number State | MA
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