Basic Information
Provider Information
NPI: 1396184644
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RICHMOND
FirstName: ADAM
MiddleName: DESMOND
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8565 S POPLAR WAY
Address2:  
City: LITTLETON
State: CO
PostalCode: 801303602
CountryCode: US
TelephoneNumber: 7203482800
FaxNumber:  
Practice Location
Address1: 8565 S POPLAR WAY
Address2:  
City: LITTLETON
State: CO
PostalCode: 801303602
CountryCode: US
TelephoneNumber: 7203482800
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/20/2013
LastUpdateDate: 07/24/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X55179CON Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084P0804X55179COY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry

No ID Information.


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