Individual
DAVID AUSTIN RIDEOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
60 WASHINGTON ST STE 403, SALEM, MA 01970-3517
(978) 594-0816
(978) 594-5878
Mailing address
1028 WASHINGTON ST, GLOUCESTER, MA 01930-1162
(978) 281-5756
(978) 281-8157
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
80575
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MR0177685A
MA CONTROLLED SUBSTANCES
MA
Enumeration date
11/24/2006
Last updated
03/07/2023
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