| Doctor Name: | MR. JEFFREY GEORGE RIEDER |
| NPI Number: | 1053337931 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | SC003897L |
| Business Practice Address: | 1234 Main St Peckville, PA - 184522043 |
| Business Phone Number: | 5704895550 |
| Business Fax Number: | 5704895958 |
| Mailing Address: | 1234 Main St, PECKVILLE |
| State: | PA |
| Postal Code: | 184522043 |
| Phone Number: | 5704895550 |
| Fax Number: | 5704895958 |
| NPI Enumeration Date: | 07/14/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | SC003897L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |