Healthcare Provider Details

I. General information

NPI: 1063730968
Provider Name (Legal Business Name): LESLIE M RIOPEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2010
Last Update Date: 08/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4410 REGENT ST ASSOCIATED PHYSICIANS, LLP
MADISON WI
53705
US

IV. Provider business mailing address

4410 REGENT ST ASSOCIATED PHYSICIANS LLP
MADISON WI
53705
US

V. Phone/Fax

Practice location:
  • Phone: 608-233-9746
  • Fax: 608-233-0026
Mailing address:
  • Phone: 608-233-9746
  • Fax: 608-233-0026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number56666-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: