Individual
DR. JASON EDWARD RIESER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5230 E STOP 11 RD STE 380, INDIANAPOLIS, IN 46237-6401
(317) 781-4588
(317) 782-4885
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01048954A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200169340A
—
IN
Enumeration date
05/27/2005
Last updated
10/17/2023
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