Provider Demographics
NPI:1871574897
Name:GOLD, RICHARD L (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:GOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 METRO CENTER BLVD STE 2000
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1785
Mailing Address - Country:US
Mailing Address - Phone:401-432-2520
Mailing Address - Fax:401-921-9212
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-5174
Practice Address - Fax:401-921-9212
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD086762085R0202X
MA516982085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
240633OtherRIHPILGRIM
77897OtherTUFTS
000000001988OtherNHPRI
300084315OtherRAILROADMEDICARE
400979OtherBLUECHIP
003122645OtherCT MED ASSISTANCE
1600025OtherUNITEDHEALTHPLANS
7004305OtherRIMEDICALASSISTANCE
720071001OtherCIGNA
008676OtherBLUESHIELD
007006230OtherHOSPITALPIN
6197736OtherMASSMEDICAID
6197736OtherHEALTHYSTART
720071001OtherCIGNA
7004305OtherRIMEDICALASSISTANCE