Healthcare Provider Details

I. General information

NPI: 1437388303
Provider Name (Legal Business Name): ERIC RILES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2009
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ROCKY MOUNTAIN AVE STE 100
LOVELAND CO
80538-9004
US

IV. Provider business mailing address

720 HARRISON AVE DOB 503
BOSTON MA
02118
US

V. Phone/Fax

Practice location:
  • Phone: 970-624-1800
  • Fax: 970-624-1891
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4301094369
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0058599
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number251219
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberDR.0058599
License Number StateCO
# 5
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberDR.0058599
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: