MEDICARE: DR. MARK DONALD RICHTER M.D.

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	207Q00000X	Family Medicine Physician	4301044337	MI

General Provider Information

NPI Number	:	1538231857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK DONALD RICHTER M.D.

Provider Business Mailing Address
First Line	:	1 FORD PL STE 3A
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-3450
Country	:	US
Telephone Number	:	313-874-4806
Fax Number	:

Provider Business Practice Location Address
First Line	:	6100 HAGGERTY
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187
Country	:	US
Telephone Number	:	734-981-3200
Fax Number	:	734-981-4354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	03/30/2026

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