Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0200X | Infectious Disease | 0101251896 | VA |
Y | 207RI0200X | Infectious Disease | 195576 | DC |
NPI | 1023361086 |
---|---|
Provider Name | Dr. Valerie Riddle |
First Address | Bumpass, VA 23024-4934 |
Second Address | Bumpass, VA 23024-4934 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2012 |
Last Update Date | 03/10/2014 |