Provider Demographics
NPI:1891144317
Name:RIEHL, RUSSELL AUGUST (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:AUGUST
Last Name:RIEHL
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GLEN COVE DR STE 108
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4237
Mailing Address - Country:US
Mailing Address - Phone:207-596-6410
Mailing Address - Fax:
Practice Address - Street 1:4 GLEN COVE DR STE 108
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4237
Practice Address - Country:US
Practice Address - Phone:207-596-6410
Practice Address - Fax:207-594-5183
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-06
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD28008207R00000X, 207RC0000X, 207RC0000X
390200000X
MO2021024979207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program