Provider Demographics
NPI:1568543353
Name:RIETHMILLER, DANIEL WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:WILLIAM
Last Name:RIETHMILLER
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 1:725 S JANESVILLE ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WI
Mailing Address - Zip Code:53563-1775
Mailing Address - Country:US
Mailing Address - Phone:608-868-5800
Mailing Address - Fax:608-868-5858
Practice Address - Street 1:725 S JANESVILLE ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:WI
Practice Address - Zip Code:53563-1775
Practice Address - Country:US
Practice Address - Phone:608-868-5800
Practice Address - Fax:608-868-5858
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL-1783207Q00000X
WI53391-20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1568543353OtherBCBSWI
WIRIETHDANOtherMERCYCARE INSURANCE
WI1568543353Medicaid
IL$$$$$$$$$ 1Medicaid
IL$$$$$$$$$ 1Medicaid
WIK400205240-000054176Medicare PIN