MEDICARE: DR. RALF K KIEHL 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	2085R0001X	Radiation Oncology Physician	200385	NY

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	:	1760483788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RALF K KIEHL MD

Provider Business Mailing Address
First Line	:	214 14TH AVE SW
Second Line	:
City	:	SIDNEY
State	:	MT
Zip	:	59270-3521
Country	:	US
Telephone Number	:	406-488-2504
Fax Number	:	406-488-2553

Provider Business Practice Location Address
First Line	:	214 14TH AVE SW
Second Line	:
City	:	SIDNEY
State	:	MT
Zip	:	59270
Country	:	US
Telephone Number	:	406-488-2504
Fax Number	:	406-488-2553

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	12/10/2020

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