Individual
DR. KEVIN P RIESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 9TH STREET NORTH, VIRGINIA, MN 55792
(218) 741-0150
Mailing address
1101 9TH STREET NORTH, VIRGINIA, MN 55792
(218) 741-0150
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
47680-20
WI
208600000X
Surgery Physician
Primary
50561
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083871586
—
MN
Enumeration date
05/21/2008
Last updated
05/10/2011
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