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NPI Code Detail

MEDICARE: DR. KATRINA YOLANDA COLE - RILEY MD

MEDICARE: DR. KATRINA YOLANDA COLE - RILEY 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
1208000000XPediatrics Physician4301502513MI

General Provider Information

NPI Number : 1932186426
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATRINA YOLANDA COLE - RILEY MD
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE # MC845
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 588 E LAKEWOOD BLVD FL 1
Second Line :
City : HOLLAND
State : MI
Zip : 49424-2023
Country : US
Telephone Number : 616-494-5840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2005
Last Update Date : 09/26/2022

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