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NPI 1669474938

NPI 1669474938 : GREGORY CLELL RIFFLE MD : MENTOR, OH

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General NPI Number Information
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    NPI Number           |    1669474938
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    Entity Type          |    Individual 
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    Provider Name        |    GREGORY CLELL RIFFLE MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/01/2005
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    Last Update Date     |    08/19/2024
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Provider Practice Location Address
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    Address Line         |    8140 NORTON PKWY STE 110 
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    City                 |    MENTOR
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    State                |    OH
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    Zip                  |    44060-6017
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    Country              |    US
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    Telephone            |    440-255-1115
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    Fax                  |    440-255-1550
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Provider Business Mailing Address
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    Address Line         |    8140 NORTON PKWY STE 110 
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    City                 |    MENTOR
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    State                |    OH
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    Zip                  |    44060-6017
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    Country              |    US
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    Telephone            |    440-255-1115
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    Fax                  |    440-255-1550
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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        |    207W00000X
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    Taxonomy Name        |    Ophthalmology Physician
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    License Number       |    35-04-2489-R
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    License Number State |    OH
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