Provider Demographics
NPI:1063730968
Name:RIOPEL, LESLIE M (MD)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:M
Last Name:RIOPEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4410 REGENT ST
Mailing Address - Street 2:ASSOCIATED PHYSICIANS LLP
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705
Mailing Address - Country:US
Mailing Address - Phone:608-233-9746
Mailing Address - Fax:608-233-0026
Practice Address - Street 1:4410 REGENT ST
Practice Address - Street 2:ASSOCIATED PHYSICIANS, LLP
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705
Practice Address - Country:US
Practice Address - Phone:608-233-9746
Practice Address - Fax:608-233-0026
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI56666-20208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1063730968Medicaid