Healthcare Provider Details

I. General information

NPI: 1881397438
Provider Name (Legal Business Name): JOSEPH RIEHM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 PARK GLEN RD
ST LOUIS PARK MN
55416-5701
US

IV. Provider business mailing address

4700 PARK GLEN RD
ST LOUIS PARK MN
55416-5701
US

V. Phone/Fax

Practice location:
  • Phone: 952-922-4200
  • Fax: 952-922-4301
Mailing address:
  • Phone: 952-922-4200
  • Fax: 952-922-4301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number81380
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: