| Doctor Name: | MATTHEW C RIESEN |
| NPI Number: | 1497947998 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 35. 099958 |
| Business Practice Address: | 1132 Hager St Saint Marys, OH - 458852423 |
| Business Phone Number: | 4193945851 |
| Business Fax Number: | 4193940702 |
| Mailing Address: | 1132 Hager St, #600 SAINT MARYS |
| State: | OH |
| Postal Code: | 458852423 |
| Phone Number: | 4193945851 |
| Fax Number: | 4193940702 |
| NPI Enumeration Date: | 08/17/2007 |
| NPI Last Update Date: | 03/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 35. 099958 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |