Individual provider · Type 1 NPI

Kevin W. Riddleberger, P.A.

Surgical Physician Assistant · Longmont, CO

NPI number 1396745683 Active

Practice location

1551 Professional Ln, Suite 200
Longmont, CO 80501-6972

Call (303) 772-1600 Map

Fax (303) 772-9317

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X1801 (CO)
Physician Assistant 363A00000X1801 (CO)

Surgical Physician Assistant: Definition to come...

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About NPI 1396745683

Kevin W. Riddleberger, P.A.'s National Provider Identifier is 1396745683, issued on Jul 28, 2005. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Longmont, CO. The record was last updated on Nov 9, 2010.