Healthcare Provider Details

I. General information

NPI: 1629487343
Provider Name (Legal Business Name): MICHAEL EDWARD RIORDAN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2014
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 OLD FERN HILL RD STE 5
WEST CHESTER PA
19380-4269
US

IV. Provider business mailing address

915 OLD FERN HILL RD STE 5
WEST CHESTER PA
19380-4269
US

V. Phone/Fax

Practice location:
  • Phone: 610-696-2850
  • Fax: 610-696-7159
Mailing address:
  • Phone: 610-696-2850
  • Fax: 610-696-7159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD476936
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD476936
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: