Provider Demographics
NPI:1033242243
Name:RIEGER, KARIN MAJ (BOC)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:MAJ
Last Name:RIEGER
Suffix:
Gender:F
Credentials:BOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 E CENTRAL
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3107 E CENTRAL
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214
Practice Address - Country:US
Practice Address - Phone:316-681-1842
Practice Address - Fax:316-684-1119
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS007582OtherBLUE CROSS BLUE SHIELD
KS007582OtherBLUE CROSS BLUE SHIELD