ELIJAH WADE RIDDLE (NPI# 1609136993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609136993 |
| Entity Type | Individual |
| Full Name | ELIJAH WADE RIDDLE |
| Credential | M.D. |
| Practice Address |
735 Norman Dr Ste 3 Lebanon PA 17042-7559 |
| Mailing Address |
3400 Spruce St Philadelphia PA 19104-4206 |
| Practice Telephone | 7172707908 |
| Practice Fax Number | 7172721734 |
| Mailing Telephone | 2156626156 |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2019-09-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | MT201557 | PA | Allopathic & Osteopathic Physicians |
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
MD454180 | PA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3401 Civic Center Blvd, Division of Surgery, Philadelphia, PA 191044319 | 2156626156 |
| Street Address |
735 NORMAN DR STE 3 |
| City | LEBANON |
| State | PA |
| Zip Code | 17042-7559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386866853 | Raman Kumar | Surgery | 735 Norman Dr Ste 3, Lebanon, PA 17042-7559 | 2007-05-03 |
| 1033750583 | Morgan E Garman | Physician Assistant | 735 Norman Dr Ste 3, Lebanon, PA 17042-7559 | 2019-10-07 |
| 1407497324 | Mckenna Giberson | Physician Assistant | 735 Norman Dr Ste 3, Lebanon, PA 17042-7559 | 2019-10-02 |
| 1710380340 | Ketankumar Dipakkumar Patel | Surgery | 735 Norman Dr Ste 3, Lebanon, PA 17042-7559 | 2014-09-26 |
| 1336583996 | Stefanni Estonilo Key | Nurse Practitioner | 735 Norman Dr Ste 3, Lebanon, PA 17042-7559 | 2013-04-24 |
| 1730433426 | Laura Lee Yoder | Nurse Practitioner | 735 Norman Dr Ste 3, Lebanon, PA 17042-7559 | 2012-11-01 |
| 1275814527 | Cindy Wu | Surgery | 735 Norman Dr Ste 3, Lebanon, PA 17042-7559 | 2011-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023676384 | Sandra L Pistone | Registered Nurse | 905 S. 2nd Ave, Lebanon, PA 17042 | 2019-06-03 |
| 1154848414 | Kihc, LLC | Home Health | 900-c Centerville Road, Suite C, Lancaster, PA 17042 | 2017-08-28 |
| 1316301724 | Good Samaritan Physician Services | Radiology | 844 Tuck Street, Lebanon, PA 17042 | 2016-04-12 |
| 1609265883 | Ashley Hess | Behavioral Analyst | 15th South 9th Street, Lebanon, PA 17042 | 2015-01-12 |
| 1932504727 | Anthony Salvadore Petrole | Physician Assistant | 252 4th Street, Lebanon, PA 17042 | 2014-10-23 |
| 1801209713 | Matthew Johnson | Family Medicine | 920 Church Street, Lebanon, PA 17042 | 2014-06-09 |
| 1437414505 | Odalys Gonzalez-rodriguez | Physical Therapist | 1700 S Lincoln Ave., Lebanon Vmac Bldg 102 Room 120, Lebanon, PA 17042 | 2012-07-05 |
| 1750677175 | Anita Lyn Stokes | Speech-Language Pathologist | 1126 Walnut Street, Lebanon, PA 17042 | 2011-06-23 |
| 1205126497 | Karey Lynn Foote | Pharmacist | 415 S. 9th St, Lebanon, PA 17042 | 2011-04-09 |
| 1013227685 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 101 E. Evergreen Road, Lebanon, PA 17042 | 2010-10-18 |
| Find all providers in zip 17042 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184868937 | Eileen Moira Duggan | Surgery | One Medical Center Dr, Lebanon, NH 03756-0001 | 2009-04-23 |
| 1245489111 | Kaveer Chatoorgoon | Surgery | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2008-09-15 |
| 1184706335 | Burton H. Harris | Surgery | One Medical Center Dr, Dartmouth-hitchcock Medical Center Div. of Pediatric, Lebanon, NH 03756-0001 | 2006-10-19 |
| 1124038302 | Laurie Latchaw | Surgery | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-08-09 |
| 1629086095 | Daniel Peter Croitoru | Surgery | 1 Medical Center Dr, Dartmouth-hitchcock Medical Center, Lebanon, NH 03756-1000 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972147239 | Children's Surgery Center of Philadelphia LLC | Surgery | 2301 E Allegheny Ave Ste 301m, Philadelphia, PA 19134-4427 | 2019-10-30 |
| 1013358084 | Kamthorn Sukarochana | Surgery | 9100 Babcock Blvd., Passavant Hosptial, Pittsburgh, PA 15237 | 2013-07-08 |
| 1336390434 | Laurence Alan Somers | Surgery | 10 Andorra Hill Rd, Lafayette Hill, PA 19444-1705 | 2008-10-07 |
| 1760661292 | John C Adkins | Surgery | 10 Holland Rd, Pittsburgh, PA 15235-5043 | 2007-11-01 |
| 1548332968 | Lehigh Valley Physician Group | Surgery | 1210 S Cedar Crest Blvd Ste 1100, Allentown, PA 18103-6241 | 2006-11-14 |
| 1770535551 | Pinnacle Health Medical Services | Surgery | 3 Walnut St Ste 205, Lemoyne, PA 17043-1168 | 2006-05-17 |
| 1457309080 | Marshall Z Schwartz | Surgery | Erie Ave At Front Street, Philadelphia, PA 19134-1095 | 2006-05-05 |
| 1952389082 | Christopher Coppola | Surgery | Geisinger Medical Ctr, 100 N. Academy Av. Mc 21-70, Danville, PA 17822-2170 | 2006-01-09 |
| 1912999848 | Kelly Miller Austin | Surgery | One Children's Hospital Drive, 4401 Penn Avenue, Children's Hospital of Pittsburgh of Upmc, Pittsburgh, PA 15224 | 2005-08-17 |
| 1174528533 | Domingo T Alvear | Surgery | 3 Walnut St, Lemoyne, PA 17043-1168 | 2005-06-14 |
| 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.