Riegle, Shannon D

Riegle, Shannon D is an individual health care provider with primary practice located at 940 Park East Blvd , Lafayette IN 47905-0792. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Riegle, Shannon D can be contacted via phone (765) 464-2280.

Contact Information

Primary practice address
940 Park East Blvd Lafayette IN 47905-0792
Phone: (765) 464-2280
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01044327A Indiana

Profile Details

NPI number 1801862677
LBN Legal business name Riegle, Shannon D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Feb 7th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801862677 NPPES
Indiana MEDICAID 200149450
Indiana Other 000000766379

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