Provider Demographics
NPI:1255344404
Name:RILEY, MONICA (MD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:RILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:HOUSTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8008 WESTPARK DR
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3109
Mailing Address - Country:US
Mailing Address - Phone:703-872-6620
Mailing Address - Fax:
Practice Address - Street 1:8008 WESTPARK DR
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3109
Practice Address - Country:US
Practice Address - Phone:703-287-6620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD32500207Q00000X
MDD0064171207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC2136646OtherALLIANCE/MAMSI
MD001487700Medicaid
DC0108724OtherUNITED HEALTHCARE
DC8136646OtherMDIPA
DC3894169002OtherCIGNA
DC036283400Medicaid
DC2852-0048OtherBC/BS
DC2852-0048OtherBC/BS