Provider Demographics
NPI:1154358927
Name:RIFFEL, DAVID EVAN (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EVAN
Last Name:RIFFEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36620 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-1134
Mailing Address - Country:US
Mailing Address - Phone:586-792-1800
Mailing Address - Fax:586-792-0612
Practice Address - Street 1:36620 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-1134
Practice Address - Country:US
Practice Address - Phone:586-792-1800
Practice Address - Fax:586-792-0612
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002367111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOM38110Medicare PIN
MIT33132Medicare UPIN
MIOEO5045Medicare ID - Type Unspecified