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NPI Code Detail

MEDICARE: MICHELLE R RILEY DO

MEDICARE: MICHELLE R RILEY DO
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
1207R00000XInternal Medicine Physician34.0035424OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00838707OTHEROHRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952370090
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE R RILEY DO
Provider Business Mailing Address
First Line : 26908 DETROIT RD
Second Line : SUITE 301
City : WESTLAKE
State : OH
Zip : 44145-2398
Country : US
Telephone Number : 440-617-1823
Fax Number : 440-617-0884
Provider Business Practice Location Address
First Line : 2535 HALE ST
Second Line : SUITE A
City : AVON
State : OH
Zip : 44011-1856
Country : US
Telephone Number : 440-934-8810
Fax Number : 440-934-8811
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 12/08/2020

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Directions to “ MICHELLE R RILEY DO” Practice Location

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