Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | MA67795 | NJ |
NPI | 1508812330 |
---|---|
Provider Name | Dr. Michael Harold Rieber |
First Address | Springfield, NJ 07081-1511 |
Second Address | West Orange, NJ 07052-2919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 03/02/2022 |