Basic Information
| Provider Information | |||||||||
| NPI: | 1457440463 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RICHES | ||||||||
| FirstName: | MARCIE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 170 MANNING DRIVE POB CB#7305 | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275997305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199624883 | ||||||||
| FaxNumber: | 9199666735 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 MANNING DRIVE | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27599 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199663048 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2006 | ||||||||
| LastUpdateDate: | 12/06/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 47123 | MN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RX0202X | ME104501 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 000866300 | 05 | FL | MEDICAID | HP42942 | 01 | MN | HEALTH PARTNERS | OTHER | 2154903 | 01 | MN | ARAZ | OTHER | 36-00511 | 01 | MN | MEDICA CHOICE | OTHER | 711085 | 01 | MN | FAIRVIEW | OTHER | 132037 | 01 | MN | UCARE | OTHER | 0079169 | 05 | MT | MEDICAID | 36-00013 | 01 | MN | MEDICA PRIMARY | OTHER | 1041329 | 01 | MN | PREFERRED ONE | OTHER |