Individual
BRUCE W RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2326 18TH ST, STE 210, COLUMBUS, IN 47201-5359
(812) 372-8426
(812) 372-8301
Mailing address
2326 18TH ST, STE 210, COLUMBUS, IN 47201-5359
(812) 372-8426
(812) 372-8301
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01044582A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000056040
ANTHEM
—
01
—
054468P
SIHO
—
01
—
1790837789
GROUP NPI
IN
05
—
200056040
—
IN
01
—
P00137831
MEDICARE RAILROAD
IN
Enumeration date
06/27/2006
Last updated
05/06/2014
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