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Individual

RATIDZAI RIOGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
10625 W NORTH AVE STE 326, WAUWATOSA, WI 53226-2315
(414) 771-0500
(414) 771-0363
Mailing address
7592 SOLUTION CENTER, #777592, CHICAGO, IL 60677-7005
(262) 641-3700
(262) 641-3719

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
41265
WI
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
41265
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
41265
STATE LICENSE
WI
Enumeration date
12/28/2006
Last updated
05/19/2022
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