Individual
MR. NICHOLAS RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4348 ELECTRIC RD, ROANOKE, VA 24018-0720
(540) 769-0950
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
0102207181
VA
207K00000X
Allergy & Immunology Physician
OS014332
PA
207R00000X
Internal Medicine Physician
0102207181
VA
208000000X
Pediatrics Physician
0102207181
VA
Other
Enumeration date
04/19/2007
Last updated
02/09/2024
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