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NPI Code Detail

MEDICARE: ANNE LOUISE RIDDLE MD

MEDICARE: ANNE LOUISE RIDDLE 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
1207Q00000XFamily Medicine Physician47263MN

General Provider Information

NPI Number : 1861413080
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE LOUISE RIDDLE MD
Provider Business Mailing Address
First Line : 6351 E SUPERIOR ST
Second Line :
City : DULUTH
State : MN
Zip : 55804-2545
Country : US
Telephone Number : 218-249-4500
Fax Number :
Provider Business Practice Location Address
First Line : 6351 E SUPERIOR ST
Second Line :
City : DULUTH
State : MN
Zip : 55804-2545
Country : US
Telephone Number : 218-249-4500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2006
Last Update Date : 01/23/2020

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Directions to “ ANNE LOUISE RIDDLE MD” Practice Location

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