Provider Demographics
NPI:1992972558
Name:RILEY, ISARETTA LEE (MD)
Entity type:Individual
Prefix:
First Name:ISARETTA
Middle Name:LEE
Last Name:RILEY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:M148 GREEN ZONE DAVISON BUILDING TRENT DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-684-8609
Mailing Address - Fax:
Practice Address - Street 1:1821 HILLANDALE RD STE 25A
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2671
Practice Address - Country:US
Practice Address - Phone:919-620-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC149977207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine