Richter, Mark Alan
Richter, Mark Alan is an sole proprietor health care provider with primary practice located at 3116 Robinhood Ln , South Bend IN 46614-2114. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Richter, Mark Alan can be contacted via phone (574) 287-4654.Contact Information
Primary practice address
3116 Robinhood Ln
South Bend IN 46614-2114
Phone: (574) 287-4654
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 01040392A | Indiana |
Profile Details
| NPI number | 1538169313 |
|---|---|
| LBN Legal business name | Richter, Mark Alan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 22nd, 2005 |
| Last updated | Jan 12th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538169313 | NPPES |
| Indiana | MEDICAID | 100326520A |
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