Individual
DR. JAMES E RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
744 S WEBSTER AVE, 2 FLOOR, GREEN BAY, WI 54301-3505
(920) 433-3640
(920) 433-3716
Mailing address
744 S WEBSTER AVE, 2 FLOOR, GREEN BAY, WI 54301-3505
(920) 433-3640
(920) 433-3716
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
44251
MN
207RC0000X
Cardiovascular Disease Physician
Primary
50202-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B10043
BCBS - MI PIN #
MI
05
—
105189687
—
MI
05
—
34191300
—
WI
Enumeration date
12/18/2006
Last updated
03/13/2014
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