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NPI Code Detail

MEDICARE: ROBERT RIEDEL M.D.

MEDICARE: ROBERT RIEDEL M.D.
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
1174400000XSpecialist019813TN
2207L00000XAnesthesiology Physician19813TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
40092839OTHERTNBCBS NUMBER

General Provider Information

NPI Number : 1679570162
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT RIEDEL M.D.
Provider Business Mailing Address
First Line : 110 29TH AVE N
Second Line : STE 202
City : NASHVILLE
State : TN
Zip : 37203-1401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 110 29TH AVE N
Second Line : STE 202
City : NASHVILLE
State : TN
Zip : 37203-1401
Country : US
Telephone Number : 615-327-4304
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 11/21/2014

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