MEDICARE: EVAN J RICHARDS 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	207L00000X	Anesthesiology Physician	0101256778	VA
2	207L00000X	Anesthesiology Physician	62619	AZ
3	207L00000X	Anesthesiology Physician	20251	NV

General Provider Information

NPI Number	:	1588009286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVAN J RICHARDS M.D.

Provider Business Mailing Address
First Line	:	LANDSTHUL REGIONAL MEDICAL CENTER
Second Line	:	UNIT 3310,0
City	:	APO
State	:	AE
Zip	:	09180-3100
Country	:	US
Telephone Number	:	850-884-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	LANDSTHUL REGIONAL MEDICAL CENTER
Second Line	:	UNIT 3310,0
City	:	APO
State	:	AE
Zip	:	09180-3100
Country	:	US
Telephone Number	:	850-884-1100
Fax Number	:

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

Provider Enumeration Date	:	05/08/2013
Last Update Date	:	11/13/2023

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