MEDICARE: DR. ETHAN CHRISTIAN RICHARD D.O

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	82176	SC
2	207Q00000X	Family Medicine Physician	2006025644	MO
3	207Q00000X	Family Medicine Physician	2019-01089	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2006025644	OTHER	MO	LICENSE

General Provider Information

NPI Number	:	1962439109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ETHAN CHRISTIAN RICHARD D.O

Provider Business Mailing Address
First Line	:	10840 VALLEY HILL RD
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29707-7452
Country	:	US
Telephone Number	:	913-291-7173
Fax Number	:

Provider Business Practice Location Address
First Line	:	885 GOLD HILL RD STE 506
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-7946
Country	:	US
Telephone Number	:	804-869-0341
Fax Number	:

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

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	08/26/2024

Similar Medicare Providers

1720651722 — STEPHANIE MARIE CLEMENTE BCBA
Practice Location Address:

885 GOLD HILL RD # 3104
FORT MILL, SC
29708-7946

Practice Phone: 803-902-5943
Practice Fax: 803-675-0443

1114608163 — AALIYAH BUSBY
Practice Location Address:

885 GOLD HILL RD # 3104
FORT MILL, SC
29708-7946

Practice Phone: 803-902-5943
Practice Fax: 803-675-0443

1992656821 — NEW BEGINNINGS BEHAVIORAL HEALTH LLC
Practice Location Address:

885 GOLD HILL RD STE 1022
FORT MILL, SC
29708-7946

Practice Phone: 704-618-9401
Practice Fax:

1114432879 — KELLY A PERRON MS, LPC, LCMHC, AADC
Practice Location Address:

885 GOLD HILL RD # 1040
FORT MILL, SC
29708-7946

Practice Phone: 803-993-8424
Practice Fax:

1285343871 — SUMMIT MEDICAL CAROLINAS LLC
Practice Location Address:

885 GOLD HILL RD # 253
FORT MILL, SC
29708-7946

Practice Phone: 720-644-9355
Practice Fax:

1811740871 — HOEFER & DAVIS LLP
Practice Location Address:

885 GOLD HILL RD # 3014
FORT MILL, SC
29708-7946

Practice Phone: 803-219-1168
Practice Fax:

Directions to “ DR. ETHAN CHRISTIAN RICHARD D.O” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.