Individual
MARK S RIDLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 METRO CENTER BLVD STE 2000, WARWICK, RI 02886-1785
(401) 432-2520
(401) 453-8220
Mailing address
125 METRO CENTER BLVD STE 2000, WARWICK, RI 02886-1785
(401) 432-2520
(401) 453-8220
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
154865
MA
2085R0202X
Diagnostic Radiology Physician
7132
RI
2085R0202X
Diagnostic Radiology Physician
Primary
MD07132
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000001988
NHPRI
—
01
—
003117240
CT MED ASSISTANCE
—
01
—
004372
BLUE CHIP
—
01
—
007000613
HOSPITAL PIN
—
01
—
007132
TUFTS
—
01
—
1600241
UNITED HEALTH PLANS
—
05
—
2013789
—
MA
01
—
240156
W&I PILGRIM
—
01
—
300067430
RAILROAD MEDICARE
—
01
—
7000613
RIMEDICAL ASSISTANCE
—
01
—
7132
FEP BLUE CROSS
—
01
—
720051701
CIGNA
—
Enumeration date
10/13/2005
Last updated
03/18/2019
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