Individual
JOHN RIEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 BREWSTER ST, DEPARTMENT OF EMERGENCY MEDICINE, PAWTUCKET, RI 02860-4400
(401) 729-2191
(401) 729-2517
Mailing address
25 WELLS ST, WESTERLY, RI 02891-2922
(401) 729-2191
(401) 729-2517
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD05718
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007061101
MEDICARE PTAN
RI
05
—
110065100A
—
MA
05
—
9001767
—
RI
Enumeration date
12/13/2005
Last updated
02/26/2019
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