Individual
PATRICK B. RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(803) 454-2613
(803) 765-1732
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4497
(803) 536-0998
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
106
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000170640
UNISON
SC
01
—
20056085
FIRST CHOICE
SC
01
—
5760010015
TRICARE
SC
01
—
576008010006
BLUE CHOICE
SC
01
—
576008010009
BCBA
SC
05
—
GAN081
—
SC
Enumeration date
04/20/2006
Last updated
11/16/2009
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