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NPI Code Detail

MEDICARE: DANIEL T RILEY MD

MEDICARE: DANIEL T RILEY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician044323GA

General Provider Information

NPI Number : 1831196682
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL T RILEY MD
Provider Business Mailing Address
First Line : PO BOX 2779
Second Line :
City : COVINGTON
State : GA
Zip : 30015-7779
Country : US
Telephone Number : 770-385-7993
Fax Number : 678-625-2029
Provider Business Practice Location Address
First Line : 5126 HOSPITAL DR NE
Second Line :
City : COVINGTON
State : GA
Zip : 30014-2566
Country : US
Telephone Number : 770-385-7993
Fax Number : 678-342-2741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 12/22/2009

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