Provider Demographics
NPI:1912976432
Name:RIESER, JOHN CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHARLES
Last Name:RIESER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3280 HOWELL MILL RD NW
Mailing Address - Street 2:SUITE 211 EAST
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327
Mailing Address - Country:US
Mailing Address - Phone:404-351-2020
Mailing Address - Fax:404-355-3703
Practice Address - Street 1:3280 HOWELL MILL RD NW
Practice Address - Street 2:SUITE 211 EAST
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327
Practice Address - Country:US
Practice Address - Phone:404-351-2020
Practice Address - Fax:404-355-3703
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2007-07-17
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Provider Licenses
StateLicense IDTaxonomies
GA10643207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00099019AMedicaid
GA00099019AMedicaid