Individual
JOHN D RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD MPH
Contact information
Practice address
9894 E 121ST ST, FISHERS, IN 46037
(317) 621-6060
(317) 355-6965
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01042451A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000220469
ANTHEM
IN
05
—
100461800
—
IN
01
—
110236660
RR MEDICARE
IL
Enumeration date
09/11/2006
Last updated
06/22/2021
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