Provider Demographics
NPI:1831114511
Name:RIGGLE, KARL P (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:P
Last Name:RIGGLE
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 1:1110 PROFESSIONAL CT
Mailing Address - Street 2:STE 101
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5937
Mailing Address - Country:US
Mailing Address - Phone:301-714-4335
Mailing Address - Fax:301-714-4334
Practice Address - Street 1:1110 PROFESSIONAL CT
Practice Address - Street 2:STE 101
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5937
Practice Address - Country:US
Practice Address - Phone:240-513-4601
Practice Address - Fax:240-513-4602
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0038764208600000X
PAMD042103L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012196800003Medicaid
MD54499100Medicaid
MD813MMedicare ID - Type Unspecified
MD813M419FMedicare PIN
E27524Medicare UPIN
PA0012196800003Medicaid