Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 5045 | SD |
NPI | 1023039021 |
---|---|
Provider Name | Gerald M Rieber |
First Address | Watertown, SD 57201-0170 |
Second Address | Watertown, SD 57201-1548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 19/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0040322 | BCBS (01) | SD |
133780700 | (05) | MN |
200044143 | RAILROAD MEDICARE (01) | |
249T2RI | BCBS (01) | MN |
6402100 | (05) | SD |
G76624 | (02) |