Active NPI 1659363752 Individual Practitioner Male Practitioner

Dr. William S Richardson , MD

Internal Medicine • Avon, OH

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. William Richardson, MD is a certified Internal Medicine practicing in Avon, OH. With approximately 33 years of clinical experience since graduating from Texas A & M University System, Hsc, College Of Medicine in 1993, Dr. Richardson delivers high-quality medical care to the local community at 2535 HALE ST.

Dr. Richardson is affiliated with University Primary Care Practices Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2535 Hale St

Avon, OH 440111856

Telephone 4409348810

Fax 4409348811

Associated Practice Facility / Clinic

🏢 Westshore Primary Care Assoc Inc Facility NPI 1063529030

Medicare Profile & Education

Medical School

Texas A & M University System, Hsc, College Of Medicine

Graduation Year

1993

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Avon, OH

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

33 Yrs +3.9 yrs vs City Avg

City Avg: 29.1 Yrs

State Avg: 26.9 Yrs

Regional Practice Density

16 Specialists

Practicing in Avon, OH (5516 Statewide)

Telehealth Adoption Rate

56.2% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

39.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Richardson (33 Years) 33 Yrs

Avon Specialty Average (29.1 Years) 29.1 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	237	70	$98.00	$71.01
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	225	48	$98.00	$71.10
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	206	206	$234.69	$124.02
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	160	106	$187.00	$120.83
99213 Established patient office or other outpatient visit, typically 15 minutes	122	101	$133.00	$86.52
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	106	55	$130.00	$102.81
99306 Initial nursing facility visit, typically 45 minutes per day	91	69	$228.00	$174.39
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	79	32	$130.00	$102.85
83036 Hemoglobin A1C level	73	44	$40.00	$9.52
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	61	61	$85.00	$53.64
G0008 Administration of influenza virus vaccine	48	47	$44.00	$30.41
90662 Influenza vaccine split virus, preservative free	46	45	$67.00	$65.66
99306 Initial nursing facility visit, typically 45 minutes per day	43	38	$228.00	$174.49
G0009 Administration of pneumococcal vaccine	35	35	$44.00	$30.47
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	35	35	$665.00	$289.98
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	24	18	$130.00	$73.41
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	19	19	$118.00	$50.76
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	14	14	$300.00	$158.18
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	13	11	$190.00	$122.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	267	93	$98.00	$72.19
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	178	178	$203.00	$123.87
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	164	36	$98.00	$72.18
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	157	101	$175.00	$121.40
99213 Established patient office or other outpatient visit, typically 15 minutes	140	104	$126.60	$85.95
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	132	61	$130.00	$103.41
99306 Initial nursing facility visit, typically 45 minutes per day	99	69	$228.00	$177.34
83036 Hemoglobin A1C level	76	46	$40.00	$9.27
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	60	28	$130.00	$103.41
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	51	51	$80.00	$54.21
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	50	50	$665.00	$282.50
G0009 Administration of pneumococcal vaccine	50	50	$44.00	$29.36
G0008 Administration of influenza virus vaccine	34	34	$44.26	$29.36
90662 Influenza vaccine split virus, preservative free	32	32	$67.00	$65.66
99306 Initial nursing facility visit, typically 45 minutes per day	30	27	$228.00	$177.33
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	19	15	$130.00	$74.22
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	15	13	$185.00	$129.77
93000 Routine ekg using at least 12 leads including interpretation and report	15	13	$72.00	$13.88
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	14	11	$193.00	$148.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	327	102	$98.00	$67.13
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	214	132	$164.96	$125.44
99306 Initial nursing facility visit, typically 45 minutes per day	142	117	$228.00	$161.57
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	141	78	$130.00	$88.46
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	135	135	$203.00	$127.94
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	98	18	$98.00	$67.16
99213 Established patient office or other outpatient visit, typically 15 minutes	87	74	$124.76	$88.67
83036 Hemoglobin A1C level	66	40	$40.00	$9.42
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	49	17	$130.00	$88.43
90662 Influenza vaccine split virus, preservative free	44	43	$67.00	$65.64
G0008 Administration of influenza virus vaccine	44	43	$44.00	$27.98
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	36	34	$78.33	$55.00
G0009 Administration of pneumococcal vaccine	30	30	$44.00	$28.16
99306 Initial nursing facility visit, typically 45 minutes per day	19	19	$228.00	$161.68
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	17	17	$293.00	$132.53
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	16	14	$221.00	$177.65
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	14	12	$185.00	$125.46
93000 Routine ekg using at least 12 leads including interpretation and report	14	13	$72.00	$13.93
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	13	12	$193.00	$130.46
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	13	13	$665.00	$278.05
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$171.00	$109.93
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$255.00	$164.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	203	119	$157.00	$127.70
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	130	130	$203.00	$130.50
99213 Established patient office or other outpatient visit, typically 15 minutes	121	101	$106.00	$89.84
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	107	53	$130.00	$89.48
99306 Initial nursing facility visit, typically 45 minutes per day	101	85	$228.00	$164.36
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	79	43	$115.00	$71.29
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	68	20	$130.00	$89.49
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	64	30	$98.00	$67.93
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	61	37	$160.00	$102.41
83036 Hemoglobin A1C level	49	30	$40.00	$9.71
99239 Hospital discharge day management, more than 30 minutes	44	44	$165.00	$104.94
G0008 Administration of influenza virus vaccine	43	43	$44.00	$16.19
90662 Influenza vaccine split virus, preservative free	42	42	$67.00	$65.26
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	32	32	$305.00	$198.60
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	26	26	$210.00	$135.02
99306 Initial nursing facility visit, typically 45 minutes per day	24	18	$228.00	$164.37
G0009 Administration of pneumococcal vaccine	24	24	$44.00	$16.17
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	23	23	$207.17	$124.35
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	20	15	$98.00	$67.94
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	13	11	$193.00	$132.87

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	244	132	$152.00	$107.03
99306 Initial nursing facility visit, typically 45 minutes per day	97	85	$228.00	$166.47
99213 Established patient office or other outpatient visit, typically 15 minutes	96	76	$103.00	$73.66
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	75	39	$98.00	$68.54
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	66	66	$203.00	$113.59
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	53	33	$160.00	$104.32
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	47	29	$115.00	$72.42
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	38	38	$305.00	$198.14
83036 Hemoglobin A1C level	37	23	$40.00	$9.67
99239 Hospital discharge day management, more than 30 minutes	34	34	$165.00	$106.81
G0008 Administration of influenza virus vaccine	32	30	$44.00	$16.01
90662 Influenza vaccine split virus, preservative free	24	24	$67.00	$60.73
99306 Initial nursing facility visit, typically 45 minutes per day	20	17	$228.00	$167.26
36415 Insertion of needle into vein for collection of blood sample	17	13	$18.00	$2.94
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	17	16	$130.00	$90.46
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	16	16	$210.00	$138.33
G0009 Administration of pneumococcal vaccine	15	15	$44.00	$16.01
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	15	15	$152.00	$118.32
99238 Hospital discharge day management, 30 minutes or less	15	15	$125.00	$72.94
99235 Initial hospital care with same-day admission and discharge with moderate level of medical decision making, per day, if using time, at least 70 minutes	13	13	$285.00	$169.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	267	130	$150.00	$104.12
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	163	66	$94.00	$66.91
99213 Established patient office or other outpatient visit, typically 15 minutes	125	91	$100.00	$71.20
36415 Insertion of needle into vein for collection of blood sample	90	61	$18.00	$2.94
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	70	38	$60.00	$42.82
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	68	41	$115.00	$71.06
99306 Initial nursing facility visit, typically 45 minutes per day	65	56	$228.00	$162.45
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	64	35	$160.00	$101.61
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	60	29	$94.00	$66.87
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	58	51	$185.00	$126.83
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	49	45	$305.00	$194.03
99239 Hospital discharge day management, more than 30 minutes	40	40	$165.00	$104.18
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	34	27	$130.00	$88.88
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	33	33	$203.00	$110.94
99306 Initial nursing facility visit, typically 45 minutes per day	31	30	$228.00	$162.44
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	28	21	$60.00	$42.87
G0008 Administration of influenza virus vaccine	24	24	$44.00	$15.75
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	23	19	$185.00	$126.80
83036 Hemoglobin A1C level	20	13	$40.00	$10.57
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	17	17	$37.00	$18.65
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	16	16	$210.00	$133.86
99235 Initial hospital care with same-day admission and discharge with moderate level of medical decision making, per day, if using time, at least 70 minutes	15	15	$285.00	$165.37
93000 Routine ekg using at least 12 leads including interpretation and report	13	11	$72.00	$16.23
99238 Hospital discharge day management, 30 minutes or less	11	11	$125.00	$71.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	209	116	$150.00	$103.27
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	192	69	$94.00	$67.46
99213 Established patient office or other outpatient visit, typically 15 minutes	148	100	$99.97	$70.19
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	129	43	$60.00	$43.43
36415 Insertion of needle into vein for collection of blood sample	119	76	$18.00	$2.92
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	95	49	$115.00	$71.31
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	77	60	$183.96	$127.27
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	71	32	$94.00	$67.44
G0008 Administration of influenza virus vaccine	53	53	$44.00	$19.30
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	50	48	$305.00	$198.71
90662 Influenza vaccine split virus, preservative free	48	48	$67.00	$52.21
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	45	21	$60.00	$43.42
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	41	29	$160.00	$102.14
99239 Hospital discharge day management, more than 30 minutes	38	38	$165.00	$105.03
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	38	14	$49.00	$19.39
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	35	35	$203.00	$111.73
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	34	32	$185.00	$127.30
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	30	19	$129.67	$89.10
99235 Initial hospital care with same-day admission and discharge with moderate level of medical decision making, per day, if using time, at least 70 minutes	29	28	$285.00	$165.98
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	27	27	$210.00	$134.04
99238 Hospital discharge day management, 30 minutes or less	25	24	$125.00	$71.28
G0009 Administration of pneumococcal vaccine	24	23	$44.00	$19.30
81002 Urinalysis, manual test	23	18	$17.00	$3.41
99231 Follow-up hospital inpatient care per day, typically 15 minutes	22	12	$85.00	$38.47
90670 Pneumococcal vaccine for injection into muscle	16	15	$319.00	$199.48
83036 Hemoglobin A1C level	16	12	$40.00	$11.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	45	39	$140.22	$102.90
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	25	15	$115.00	$70.41
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	24	15	$94.00	$66.80
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	19	15	$60.00	$43.19
G0008 Administration of influenza virus vaccine	19	19	$44.00	$23.76
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	19	19	$94.00	$66.80
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	17	16	$305.00	$197.76
90662 Influenza vaccine split virus, preservative free	17	17	$67.00	$48.05
99213 Established patient office or other outpatient visit, typically 15 minutes	16	14	$95.00	$69.80
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	16	16	$60.00	$43.19
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	13	12	$165.00	$126.53
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	12	11	$168.33	$126.53
36415 Insertion of needle into vein for collection of blood sample	12	12	$18.00	$2.94
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	11	11	$203.00	$110.51

Medical Specialties & State Licenses

CMS Verified: 2020-11-10

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License OH 35072474

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

2061021 (OH)

Commercial Insurance / Payer ID Rr Medicare

110162326 (OH)

Hospital & Practice Group Affiliations

University Primary Care Practices Inc

158 W Main Rd, Conneaut, OH 440302039

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners

Aubrey Shearn , FNP-C

Nurse Practitioner - Family

NPI 1083990964

Family Nurse Practitioner (Certified)

Dr. Laura Davis Luarde , DO

Internal Medicine

NPI 1114919222

Doctor of Osteopathic Medicine (D.O.)

Dr. Sarah Johnson , DO

Internal Medicine

NPI 1316527872

Doctor of Osteopathic Medicine (D.O.)

Dr. Matthew Kacir , MD

Pediatrics

NPI 1477555357

Doctor of Medicine (M.D.)

Irene Grabovac , NP

Nurse Practitioner - Family

NPI 1518356864

Nurse Practitioner

Dr. Andrew Filiatraut , DO

Internal Medicine

NPI 1891755591

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active September 06, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location September 06, 2016

Registered at 2535 HALE ST, AVON, OH 440111856 (Tel: 4409348810)

📍

Updated Business Mailing Address September 06, 2016

Registered at 26908 DETROIT RD, SUITE 301, WESTLAKE, OH 441452398 (Tel: 4406171823)

👤

Provider Name / Credentials Updated September 06, 2016

Recorded as WILLIAM RICHARDSON, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 06, 2016

Internal Medicine (License #35072474 in OH)

🟢

Initial NPI Registration & Enumeration August 16, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1659363752

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 16, 2005

Last Update: November 10, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

26908 Detroit Rd, Suite 301

Westlake, OH 441452398

Phone: 4406171823

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.