Basic Information
| Provider Information | |||||||||
| NPI: | 1740292341 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIAR | ||||||||
| FirstName: | NAVDEEP | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 708850 | ||||||||
| Address2: | |||||||||
| City: | SANDY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840708782 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668692395 | ||||||||
| FaxNumber: | 8013529502 | ||||||||
| Practice Location | |||||||||
| Address1: | 1460 G ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974774112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417448555 | ||||||||
| FaxNumber: | 5417446150 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2006 | ||||||||
| LastUpdateDate: | 12/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A94571 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 028544 | 05 | OR | MEDICAID | 838334031 | 01 | OR | BCBS-ROSEBURG | OTHER | 844477033 | 01 | OR | BCBS-GRANTS PASS | OTHER | 858463031 | 01 | OR | BCBS-MEDFORD | OTHER | P00439412 | 01 | OR | RAIL ROAD MEDICARE | OTHER | 858464035 | 01 | OR | BCBS-SPRINGFIELD | OTHER | R136910 | 01 | OR | MEDICARE-TYPE UNSPECIFIED | OTHER | 838366028 | 01 | OR | BCBS-MCMINNVILLE | OTHER |