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General NPI Number Information
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NPI Number | 1144541392
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Entity Type | Individual
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Provider Name | MAUREEN B. RIFFLE M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/22/2010
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Last Update Date | 06/22/2010
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Provider Practice Location Address
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Address Line | 3023 N BALLAS RD SUITE 520 D
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2330
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Country | US
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Telephone | 314-569-2620
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Fax | 314-996-6902
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Provider Business Mailing Address
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Address Line | 200 BREVCO PLZ SUITE 208
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City | LAKE SAINT LOUIS
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State | MO
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Zip | 63367-2949
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Country | US
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Telephone | 636-561-6603
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Fax | 636-561-6208
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | R5D44
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License Number State | MO
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