Individual
DAVID J RIDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3747 ROSWELL RD STE 201, MARIETTA, GA 30062
(770) 578-2868
Mailing address
805 SANDY PLAINS ROAD, MEDICAL STAFF SERVICES, MARIETTA, GA 30066-6340
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
31240
TN
2088P0231X
Pediatric Urology Physician
Primary
39916
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3841062
—
TN
Enumeration date
09/13/2005
Last updated
10/30/2019
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