DR. RICHARD ALLEN DOUGLAS (NPI# 1710961669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710961669 |
| Entity Type | Individual |
| Full Name | DR. RICHARD ALLEN DOUGLAS |
| Credential | M.D.,F.A.C.S. |
| Practice Address |
527 Medical Park Drive Suite 401 Bridgeport WV 26330 |
| Practice Telephone | 6813423500 |
| Practice Fax Number | 6813423561 |
| Mailing Telephone | 6813423500 |
| Mailing Fax Number | 6813423561 |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2013-02-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 20050 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | BC/BS | 001709481 | 01 |
| WV | 0088893000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033105515 | Richard N Douglas | Optometrist | 10431 Patterson Ave, Richmond, VA 23238-5101 | 2005-09-21 |
| 1588904122 | Richard P Douglas | Behavioral Analyst | 2505 Black Rock Tpke, 2nd Floor, Fairfield, CT 06825-2408 | 2013-02-19 |
| 1528220126 | Richard C Douglas | Dentist | 660 N State Road 7, Suite 12, Plantation, FL 33317-2117 | 2008-06-26 |
| 1710935804 | Richard Douglas | Physician Assistant | 3600 30th St, Primary Care, Des Moines, IA 50310-5876 | 2006-05-04 |
| 1659336824 | Richard D. Douglas | Occupational Therapist | 801 Tilton Rd, Novacare, Northfield, NJ 08225-1265 | 2006-04-19 |
| Street Address |
527 MEDICAL PARK DRIVE SUITE 401 |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346730504 | Khaldoun Mohamad Mozahem | Psychiatry & Neurology | 527 Medical Park Drive, Suite 204, Bridgeport, WV 26330 | 2018-05-14 |
| 1750682910 | Physician Office Building- Uhc | Obstetrics & Gynecology | 527 Medical Park Drive, Suite 108, Bridgeport, WV 26330-9007 | 2010-11-04 |
| 1659524635 | Advanced Diabetes & Endocrine Center | Internal Medicine | 527 Medical Park Drive, Suite 103, Bridgeport, WV 26330-9009 | 2008-11-04 |
| 1023196391 | United Hospital Center, Inc | Anesthesiology | 527 Medical Park Drive, Ste 402, Bridgeport, WV 26330 | 2006-11-02 |
| 1306929476 | United Hospital Center, Inc | Neurological Surgery | 527 Medical Park Drive, Ste 401, Bridgeport, WV 26330 | 2006-10-23 |
| 1124114574 | Mazen Nashed | Internal Medicine | 527 Medical Park Drive, Suite 204, Bridgeport, WV 26330 | 2006-10-05 |
| 1003900283 | Saad Mossallati | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 527 Medical Park Drive, Suite 204, Bridgeport, WV 26330 | 2006-10-03 |
| 1497847651 | James Lee Bryant II | Otolaryngology | 527 Medical Park Drive, Suite 501, Bridgeport, WV 26330 | 2006-09-28 |
| 1881709970 | Syed N Haq | Internal Medicine | 527 Medical Park Drive, Suite 103, Bridgeport, WV 26330-9009 | 2006-08-20 |
| 1871531897 | Clarksburg Cardiology Consultants | Internal Medicine | 527 Medical Park Drive, Ste 306, Bridgeport, WV 26330-9008 | 2006-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477737328 | Patrick P Mastroianni Md PC | Neurological Surgery | 340 Capital Ave, Bridgeport, CT 06606 | 2007-12-27 |
| 1265621163 | Michael E Opalak Md PC | Neurological Surgery | 340 Capitol Avenue, Bridgeport, CT 06606 | 2007-10-17 |
| 1538364914 | Vincent J Miele | Neurological Surgery | 527 Medical Park Drive, Suite 401, Uhc Neurosurgery & Spine Center, Bridgeport, WV 26300 | 2007-06-18 |
| 1164452413 | Daniel Edgardo Nijensohn | Neurological Surgery | 340 Capitol Ave, Bridgeport, CT 06606-5445 | 2006-07-03 |
| 1790764850 | Bill D. Underwood | Neurological Surgery | 227 Medical Park Dr Ste 103, Bridgeport, WV 26330-8421 | 2006-01-17 |
| 1891164000 | Mary Anne Varner | Neurological Surgery | 227 Medical Park Drive, Suite 103, Bridgeport, WV 26330 | 2015-09-17 |
| 1326237256 | Daniel E Nijensohn Md PC | Neurological Surgery | 340 Capitol Ave, Bridgeport, CT 06606 | 2007-10-16 |
| 1902000276 | Connecticut Neurosurgical Specialists, P.C. | Neurological Surgery | 267 Grant Street, Schine 8, Bridgeport, CT 06610-2805 | 2007-06-12 |
| 1306929476 | United Hospital Center, Inc | Neurological Surgery | 527 Medical Park Drive, Ste 401, Bridgeport, WV 26330 | 2006-10-23 |
| 1699783647 | Michael Ernest Opalak | Neurological Surgery | 340 Capitol Ave, Bridgeport, CT 06606 | 2006-08-04 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.