Individual
TODD RIDENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1230 E RUSHOLME ST STE 303, DAVENPORT, IA 52803-2400
(563) 383-2763
(563) 328-5500
Mailing address
1230 E RUSHOLME ST STE 303, DAVENPORT, IA 52803-2400
(563) 383-2763
(563) 328-5500
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
27062
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0088971
—
IA
01
—
08196
BCBS
IA
Enumeration date
11/02/2005
Last updated
08/11/2021
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