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Individual

MARI A RILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
875 S VANGUARD WAY, MERIDIAN, ID 83642-7552
(208) 463-3000
Mailing address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 463-3000
(208) 463-3044

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
46613
WI
207Q00000X
Family Medicine Physician
DR49628
CO
207Q00000X
Family Medicine Physician
Primary
M-13163
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
34576000
WI
Enumeration date
08/30/2006
Last updated
07/21/2021
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