Provider Demographics
NPI:1750510327
Name:RIAL, NATHANIEL S (MD/PHD/MPH)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:S
Last Name:RIAL
Suffix:
Gender:M
Credentials:MD/PHD/MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 BREWSTER BLVD
Mailing Address - Street 2:NAVAL HOSPITAL
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28547-2538
Mailing Address - Country:US
Mailing Address - Phone:910-450-4159
Mailing Address - Fax:910-450-4194
Practice Address - Street 1:NAVAL HOSPITAL
Practice Address - Street 2:100 BREWSTER BLVD
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:28547-2538
Practice Address - Country:US
Practice Address - Phone:910-450-4159
Practice Address - Fax:910-450-4194
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-04
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZR71672207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZR71672OtherARIZONA MEDICAL BOARD