Individual
DR. MARK RIEDY
Active
Individual
DR. MARK RIEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
22748
SC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
54662
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02914
BCBS
NC
05
—
100017364
—
WI
05
—
227481
—
SC
05
—
8902914
—
NC
01
—
CM7718
RAILROAD MEDICARE
—
05
—
GP1062
—
SC
01
—
GP3912
MEDICAID GROUP
SC
01
—
GP4306
MEDICAID GROUP
SC
01
—
H503647762
H503647762
SC
Enumeration date
07/07/2005
Last updated
02/05/2026
Update your record
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