Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 2008011487 | MO |
Y | 208800000X | Urologist | 25963 | WV |
NPI | 1033381108 |
---|---|
Provider Name | Dr. John Francis Riordan |
First Address | Martinsburg, WV 25401-9000 |
Second Address | Martinsburg, WV 25401-9401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2008 |
Last Update Date | 08/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033381108 | MEDICAID-ST. FRANCIS HOSPITAL (01) | MO |
3810027652 | (05) | WV |
E26000017 | MEDICARE-ST. FRANCIS (01) | MO |