DR. ANDREW JEROME RIDDLE (NPI# 1215059670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215059670 |
| Entity Type | Individual |
| Full Name | DR. ANDREW JEROME RIDDLE |
| Credential | DO |
| Practice Address |
217 S Madison Street Traverse MI 49684 |
| Mailing Address |
2513 Momentum Pl Chicago IL 60689-5325 |
| Practice Telephone | 2313928400 |
| Practice Fax Number | 2319357888 |
| Mailing Telephone | 2319356080 |
| Mailing Fax Number | 2319356081 |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2018-08-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
5101016771 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053409441 | Andrew W Riddle | Chiropractor | 375 Mullet Run Street, Milford, DE 19963 | 2006-10-11 |
| 1285081356 | Andrew Scott Riddle | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2016-05-18 |
| Street Address |
217 S MADISON STREET |
| City | TRAVERSE |
| State | MI |
| Zip Code | 49684 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346887692 | Michigan Center for Hematology and Oncology | Internal Medicine | 28111 Hoover Rd Ste 5a, Warren, MI 48093-4153 | 2019-12-05 |
| 1487093274 | Heidi M Egloff | Internal Medicine | 1140 E Michigan Ave, Lansing, MI 48912-1805 | 2013-06-14 |
| 1588008809 | Roba Alhasan | Internal Medicine | 4900 Mercury Dr Ste 100, Dearborn, MI 48126-2947 | 2013-04-18 |
| 1285975151 | David Allen Leichtman | Internal Medicine | 5216 Mirror Lake Ct, West Bloomfield, MI 48323-1536 | 2013-03-02 |
| 1184988750 | Musnon Medical Center | Internal Medicine | 4960 Skyview Court, Traverse City, MI 49684-7173 | 2012-06-28 |
| 1659634772 | Leann Michelle Blankenship | Internal Medicine | 3577 W 13 Mile Rd Ste 202, Royal Oak, MI 48073-6710 | 2012-06-22 |
| 1609160928 | Iha Health Services Corporation | Internal Medicine | 5301 E Huron River Dr Ste 210, Ypsilanti, MI 48197-1051 | 2011-06-03 |
| 1366733156 | Nakul Singhal | Internal Medicine | 5015 Oak Tree Ct, Ann Arbor, MI 48108-8573 | 2011-04-27 |
| 1275859704 | Elon Knoll | Internal Medicine | 11885 E 12 Mile Rd Ste 100a, Warren, MI 48093-3465 | 2010-04-08 |
| 1598911448 | Mohammad Muhsin Chisti | Internal Medicine | 44199 Dequindre Rd Ste G-10, Troy, MI 48085-1128 | 2008-08-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.