DR. Mal S. Riddell, D.O.

NPI #1083613210 in Grenada, Mississippi

Provider Information

NPI Number: 1083613210
Entity Type: Individual
Name: DR. Mal S. Riddell, D.O.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Family Medicine
Credential: D.O.
Enumeration Date: Jul 19, 2005
Last Updated: Jan 6, 2017

Practice Location

Address: 1300 SUNSET DR
Address 2: SUITE B
City: Grenada
State: Mississippi
ZIP Code: 38901-4086
Phone: (662) 226-6430

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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