Individual
EDWARD RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2520 5TH ST N, COLUMBUS, MS 39705-2008
(904) 805-1300
(904) 805-1302
Mailing address
PO BOX 75473, BALTIMORE, MD 21275-5473
(904) 805-1300
(904) 805-1302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
10465
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118034
—
MS
01
—
009972530
ALABAMA MEDICAID
MS
01
—
562251777
BLUE CROSS
MS
Enumeration date
06/02/2006
Last updated
04/29/2008
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