Basic Information
| Provider Information | |||||||||
| NPI: | 1033147558 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HIRSCHLER | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5515 CLEVELAND AVENUE | ||||||||
| Address2: | SUUITE 6 | ||||||||
| City: | STEVENSVILLE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2694299677 | ||||||||
| FaxNumber: | 2694294002 | ||||||||
| Practice Location | |||||||||
| Address1: | 5515 CLEVELAND AVENUE | ||||||||
| Address2: | SUUITE 6 | ||||||||
| City: | STEVENSVILLE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2694299677 | ||||||||
| FaxNumber: | 2694294002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 07/21/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 4301029501 | MI | N | Other Service Providers | Specialist | 208D00000X | 01029311A | IN | Y | Allopathic & Osteopathic Physicians | General Practice |
ID Information
| ID | Type | State | Issuer | Description | 4758016 | 05 | MI | MEDICAID | CIGNA | 01 | 4840301 | OTHER | BLUE CROSS | 01 | MI | 101110742 | OTHER | PHP | 01 | MI | 01-31419 | OTHER | 4886571 | 05 | MI | MEDICAID |