Storm, Richard Mason
Storm, Richard Mason is an sole proprietor health care provider with primary practice located at 622 N Madison Ave Ste 5, Greenwood IN 46142-4052. He recently has only one registered license in Allopathic & Osteopathic Physicians / Procedural Dermatology, which is considered as his primary health care specialty. Storm, Richard Mason can be contacted via phone (317) 743-8930.Contact Information
Primary practice address
622 N Madison Ave Ste 5
Greenwood IN 46142-4052
Phone: (317) 743-8930
Fax: (317) 743-8937
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | 01029002A | Indiana |
Profile Details
| NPI number | 1922003086 |
|---|---|
| LBN Legal business name | Storm, Richard Mason |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 16th, 2005 |
| Last updated | Nov 29th, 2016 - about 10 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 | 1922003086 | NPPES |
| Indiana | Other | 15D0352826 | CLIA |
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