Healthcare Provider Details
I. General information
NPI: 1154701696
Provider Name (Legal Business Name): MATTHEW RIESBECK D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/30/2015
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
509 BILTMORE AVE
ASHEVILLE NC
28801-4601
US
IV. Provider business mailing address
509 BILTMORE AVE
ASHEVILLE NC
28801-4601
US
V. Phone/Fax
- Phone: 828-213-0152
- Fax: 828-213-7053
- Phone: 828-213-0152
- Fax: 828-213-7053
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 5315069662 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RA0001X |
| Taxonomy | Advanced Heart Failure and Transplant Cardiology Physician |
| License Number | 202302479 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: