MEDICARE: SETH J RIALS MD

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
1	207RC0000X	Cardiovascular Disease Physician	35076406R	OH
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	35076406	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306887823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SETH J RIALS MD

Provider Business Mailing Address
First Line	:	765 N HAMILTON RD
Second Line	:	SUITE 120
City	:	GAHANNA
State	:	OH
Zip	:	43230-8703
Country	:	US
Telephone Number	:	614-337-9800
Fax Number	:	614-269-1132

Provider Business Practice Location Address
First Line	:	765 N HAMILTON RD
Second Line	:	SUITE 120
City	:	GAHANNA
State	:	OH
Zip	:	43230-8703
Country	:	US
Telephone Number	:	614-337-9800
Fax Number	:	614-269-1132

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	09/11/2008

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