Basic Information
| Provider Information | |||||||||
| NPI: | 1922118934 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATTERSON | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3605 WARRENSVILLE CENTER ROAD | ||||||||
| Address2: | MSC9152 | ||||||||
| City: | SHAKER HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162866299 | ||||||||
| FaxNumber: | 2162866341 | ||||||||
| Practice Location | |||||||||
| Address1: | 11100 EUCLID AVENUE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168441700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 05/23/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 069676 | OH | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 35069676 | OH | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 731514 | 01 | OH | BUCKEYE COMM HEALTH PLAN | OTHER | CN1167 | 01 | OH | RRMC | OTHER | 000000221312 | 01 | OH | UNISON | OTHER | 2026202 | 05 | OH | MEDICAID | 300084158 | 01 | OH | RAILROAD MEDICARE | OTHER | 751195 | 01 | OH | BUCKEYE | OTHER | CF7408 | 01 | OH | RRMC | OTHER | 7384635 | 01 | OH | AETNA | OTHER | 0304914 | 01 | OH | BCMH | OTHER | CC3678 | 01 | OH | RRMC | OTHER | 000000516405 | 01 | OH | ANTHEM | OTHER | 000000025902 | 01 | OH | ANTHEM BC/BS | OTHER | 363905 | 01 | OH | WELLCARE | OTHER |