Healthcare Provider Details

I. General information

NPI: 1437442886
Provider Name (Legal Business Name): NATALYA RIEK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2011
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3735 GLENLAKE DR STE 250
CHARLOTTE NC
28208-6866
US

IV. Provider business mailing address

2162 DEER RUN DR
HUMMELSTOWN PA
17036-7066
US

V. Phone/Fax

Practice location:
  • Phone: 704-704-9580
  • Fax: 704-626-3237
Mailing address:
  • Phone: 336-501-7383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberOT015589
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2023-02045
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: