Individual
MICHAEL ALLEN RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5470 EAST 16TH STREET, INDIANAPOLIS, IN 46218-4861
(317) 355-5009
(317) 351-7804
Mailing address
8180 CLEARVISTA PARKWAY, SUITE 230 ATTN SHERRY MUELLER, INDIANAPOLIS, IN 46256-4649
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01065010A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200922400
—
IN
Enumeration date
06/15/2007
Last updated
12/06/2012
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