Individual
ROBERT R RIEDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1040 DIVISION ST, MAUSTON, WI 53948-1931
(608) 847-5000
Mailing address
1040 DIVISION ST, MAUSTON, WI 53948-1931
(608) 847-5000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01063344A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000511377
ANTHEM
—
05
—
200854000A
—
IN
05
—
200854000T
—
IN
05
—
31804200
—
WI
Enumeration date
03/21/2007
Last updated
08/25/2008
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