Randal Paul Riesett, MD | |
2470 Longstone Ln Ste I, Marriottsville, MD 21104-1523 | |
(410) 910-2300 | |
(410) 740-9134 |
Full Name | Randal Paul Riesett |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Experience | 25 Years |
Location | 2470 Longstone Ln Ste I, Marriottsville, Maryland |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396738779 | NPI | - | NPPES |
512509000 | Medicaid | MD | |
B6100007 | Other | DC | BC/BS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | D0058747 (Maryland) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
The Lutheran Village At Miller's Grant | Ellicott city, MD | Nursing home |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Charter Internal Medicine, Llc | 0244204113 | 2 |
Entity Name | Charter Internal Medicine, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750492419 PECOS PAC ID: 0244204113 Enrollment ID: O20040825000968 |
Mailing Address | Practice Location Address |
---|---|
Randal Paul Riesett, MD 2470 Longstone Ln Ste I, Marriottsville, MD 21104-1523 Ph: (410) 910-2300 | Randal Paul Riesett, MD 2470 Longstone Ln Ste I, Marriottsville, MD 21104-1523 Ph: (410) 910-2300 |
Jonathan Scott Fish, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2470 Longstone Ln Ste I, Marriottsville, MD 21104 Phone: 410-910-2300 Fax: 410-740-9134 | |
Elizabeth S Bower, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2400 Longstone Ln Ste 106, Marriottsville, MD 21104 Phone: 410-480-1895 Fax: 410-480-4955 | |
Ji Yon Kwon, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2400 Longstone Ln Ste 106, Marriottsville, MD 21104 Phone: 410-480-1895 Fax: 410-480-4955 |