Individual
DAVID E RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
23905 MERCANTILE RD, BEACHWOOD, OH 44122-5925
(216) 200-3897
Mailing address
PO BOX 1086, WILLOUGHBY, OH 44096-1086
(216) 645-7242
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
35-052141
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221245
UNISON
OH
01
—
000000510683
ANTHEM
OH
05
—
0771991
—
OH
01
—
0964458
AETNA
OH
01
—
130017943
MCR RR
—
01
—
363955
WELLCARE MEDICAID
OH
01
—
741879
BUCKEYE MEDICAID
OH
01
—
P00398388
MEDICARE RAILROAD
OH
Enumeration date
07/18/2006
Last updated
01/18/2021
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