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General NPI Number Information
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NPI Number | 1669566691
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Entity Type | Individual
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Provider Name | LISA RIDER MD
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 04/03/2009
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Provider Practice Location Address
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Address Line | CLINICAL RESEARCH CTR 10 CENTER DRIVE
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City | BETHESDA
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State | MD
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Zip | 20892-0001
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Country | US
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Telephone | 301-496-1211
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Fax |
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Provider Business Mailing Address
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Address Line | NIEHS NIH CRC 4-2352, MSC 1301, 10 CENTER DRIVE
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City | BETHESDA
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State | MD
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Zip | 20892-0001
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Country | US
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Telephone | 301-451-6272
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Fax | 301-451-5588
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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 | 2080P0216X
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Taxonomy Name | Pediatric Rheumatology Physician
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License Number | MD035811
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 2080P0216X
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Taxonomy Name | Pediatric Rheumatology Physician
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License Number | D46950
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License Number State | MD
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