MEDICARE: DR. DILLON JAMES RIEBEL 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	208000000X	Pediatrics Physician	15776A	WY

General Provider Information

NPI Number	:	1760019616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DILLON JAMES RIEBEL MD

Provider Business Mailing Address
First Line	:	7700 E 29TH AVE UNIT 101
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80238-2918
Country	:	US
Telephone Number	:	720-514-2250
Fax Number	:

Provider Business Practice Location Address
First Line	:	7700 E 29TH AVE UNIT 101
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80238-2918
Country	:	US
Telephone Number	:	720-514-2250
Fax Number	:

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

Provider Enumeration Date	:	03/23/2020
Last Update Date	:	06/29/2023

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