Provider Demographics
NPI:1033381108
Name:RIORDAN, JOHN FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FRANCIS
Last Name:RIORDAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 FOUNDATION WAY
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-9000
Mailing Address - Country:US
Mailing Address - Phone:304-264-9202
Mailing Address - Fax:304-264-9042
Practice Address - Street 1:880 N TENNESSEE AVE STE 105
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-9401
Practice Address - Country:US
Practice Address - Phone:304-596-5757
Practice Address - Fax:304-596-5758
Is Sole Proprietor?:No
Enumeration Date:2008-03-29
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008011487208800000X
WV25963208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOE26000017OtherMEDICARE-ST. FRANCIS
WV3810027652Medicaid
MO1033381108OtherMEDICAID-ST. FRANCIS HOSPITAL
WV3810027652Medicaid
MOB8300001Medicare PIN