Individual
DR. CHARLES MICHAEL RISSLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2373 E MAIN ST, PLAINFIELD, IN 46168-2717
(317) 839-0713
(317) 837-4093
Mailing address
1125 BALTUSTROL RUN, AVON, IN 46123-7067
(317) 696-7851
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001745A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000385426
ANTHEM BCBS
IN
05
—
100193380
—
IN
Enumeration date
04/25/2006
Last updated
11/09/2011
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