Individual
DR. MARICEL LILIAN RIDELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
704 THIMBLE SHOALS BLVD, BUILDING 300A, NEWPORT NEWS, VA 23606
(757) 595-4300
(757) 591-9297
Mailing address
860 OMNI BLVD, SUITE 303, NEWPORT, VA 23662-1027
(757) 232-8769
(757) 232-8875
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
0101252641
VA
390200000X
Student in an Organized Health Care Education/Training Program
A110936
CA
390200000X
Student in an Organized Health Care Education/Training Program
BP1-0027842
TX
Other
Enumeration date
08/14/2007
Last updated
09/04/2012
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