Individual
PAUL S RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1434 CHESTER BLVD, RICHMOND, IN 47374-1947
(765) 966-5527
(765) 966-5527
Mailing address
1100 REID PARKWAY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374
(765) 983-3127
(765) 983-3219
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01023981A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000082699
ANTHEM
IN
05
—
0651816
—
OH
01
—
100256020
MANAGED HEALTH SERVICES
IN
05
—
100256020
—
IN
01
—
351265355
TAX ID
IN
Enumeration date
07/10/2006
Last updated
03/07/2023
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