MEDICARE: RODNEY CHARLES RICHIE 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	207RP1001X	Pulmonary Disease Physician	D9628	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8AV862	OTHER	TX	BCBS OF TX

General Provider Information

NPI Number	:	1750362398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODNEY CHARLES RICHIE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 18962
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4084
Country	:	US
Telephone Number	:	800-566-5050
Fax Number	:	254-537-6869

Provider Business Practice Location Address
First Line	:	7003 WOODWAY DR
Second Line	:	SUITE 311
City	:	WACO
State	:	TX
Zip	:	76712-6170
Country	:	US
Telephone Number	:	254-741-1688
Fax Number	:	254-741-9767

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	01/06/2017

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Directions to “ RODNEY CHARLES RICHIE M.D.” Practice Location

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