Provider Demographics
NPI:1740292341
Name:RIAR, NAVDEEP (MD)
Entity type:Individual
Prefix:
First Name:NAVDEEP
Middle Name:
Last Name:RIAR
Suffix:
Gender:F
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:PO BOX 708850
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-8782
Mailing Address - Country:US
Mailing Address - Phone:866-869-2395
Mailing Address - Fax:801-352-9502
Practice Address - Street 1:1460 G ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-4112
Practice Address - Country:US
Practice Address - Phone:541-744-8555
Practice Address - Fax:541-744-6150
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94571207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR028544Medicaid
OR838334031OtherBCBS-ROSEBURG
OR844477033OtherBCBS-GRANTS PASS
OR858463031OtherBCBS-MEDFORD
ORP00439412OtherRAIL ROAD MEDICARE
OR858464035OtherBCBS-SPRINGFIELD
ORR136910OtherMEDICARE-TYPE UNSPECIFIED
OR838366028OtherBCBS-MCMINNVILLE
OR028544Medicaid
OR136899Medicare PIN
OR135263Medicare PIN