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General NPI Number Information
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NPI Number | 1104001619
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Entity Type | Organization
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Legal Business Name | DR. ROBERT SCOTT RIEDER D.P.M.
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 9515 HARFORD RD
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City | BALTIMORE
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State | MD
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Zip | 21234-3124
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Country | US
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Telephone | 410-668-7007
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Fax |
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Provider Business Mailing Address
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Address Line | 12 QUELET PL
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City | NOTTINGHAM
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State | MD
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Zip | 21236-1551
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Country | US
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Telephone | 443-413-5640
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF PODIATRIC MEDICINE
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Name | DR. ROBERT SCOTT RIEDER
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Credential | DPM
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Telephone | 443-413-5640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 01116
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 01116
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License Number State | MD
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