Individual
CODY RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2600 6TH ST SW, CANTON, OH 44710
(330) 363-3926
Mailing address
2600 6TH ST SW, CANTON, OH 44710
(330) 456-2695
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34.011190
OH
207P00000X
Emergency Medicine Physician
OS017479
PA
Other
Enumeration date
04/09/2012
Last updated
07/01/2022
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