Individual
MARK A RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5500 KNOLL NORTH DR STE 370, COLUMBIA, MD 21045-2393
(410) 837-2050
(866) 629-0091
Mailing address
1111 N CHARLES ST, BALTIMORE, MD 21201-5505
(410) 837-2050
(866) 629-0091
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
D0045696
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162501200
—
MD
Enumeration date
06/12/2006
Last updated
07/21/2022
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