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NPI Code Detail

MEDICARE: MARIAH REIL MS, RD, LN

MEDICARE: MARIAH REIL MS, RD, LN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian0731SD
2133V00000XRegistered Dietitian5478MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
186132732OTHERCDR RD REGISTRATION NUMBER
20731OTHERSDLICENSED NUTRITIONIST

General Provider Information

NPI Number : 1205440492
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAH REIL MS, RD, LN
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1300 ANNE ST NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-5103
Country : US
Telephone Number : 218-333-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2020
Last Update Date : 12/29/2025

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