MEDICARE: RICHMOND OB GYN PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	29343	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	58798	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457348732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHMOND OB GYN PA

Provider Business Mailing Address
First Line	:	PO BOX 304
Second Line	:
City	:	ROCKINGHAM
State	:	NC
Zip	:	28380-0304
Country	:	US
Telephone Number	:	910-417-3477
Fax Number	:	910-417-3489

Provider Business Practice Location Address
First Line	:	921 S LONG DR
Second Line	:	STE 207
City	:	ROCKINGHAM
State	:	NC
Zip	:	28379-4874
Country	:	US
Telephone Number	:	910-417-3477
Fax Number	:	910-417-3489

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PATRICIA L MIDDLETON
Credential	:	MD FACS
Telephone Number	:	910-417-3477

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	08/22/2020

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Directions to “RICHMOND OB GYN PA ” Practice Location

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