Individual
WOUTER J RIETSEMA
Active
Individual
WOUTER J RIETSEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
195737
NY
207RI0200X
Infectious Disease Physician
Primary
195737
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000405209002
BS OF NENY
NY
05
—
01561260
—
NY
01
—
044661958
HEALTH NET
NY
01
—
09004310
EMPIRE BC BS
NY
01
—
114406
VALUE OPTIONS
NY
01
—
119037
MVP
NY
01
—
141338471
GHI
NY
01
—
440002865
RAILROAD MEDICARE
NY
01
—
7423705
AETNA
NY
01
—
P010195737
EXCELLUS UTICA WATERTOWN
NY
Enumeration date
01/02/2007
Last updated
12/20/2012
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