Randal Paul Riesett (NPI# 1396738779, PAC ID# 5092901033) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1396738779 |
| PAC ID by PECOS | 5092901033 |
| Professional Enrollment ID | I20101202000136 |
| Full Name | Randal Paul Riesett |
| Organization Legal Name | CHARTER INTERNAL MEDICINE, LLC |
| Address |
2470 Longstone Ln Suite I Marriottsville MD 21104-1523 |
| Phone Number | 4109102300 |
| Gender | M |
| Medical School | UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 0244204113 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 210048 | HOWARD COUNTY GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2470 Longstone Ln, Suite I, Marriottsville, MD 21104-1523 | 4109102300 | CHARTER INTERNAL MEDICINE, LLC |
| Organization Legal Name | CHARTER INTERNAL MEDICINE, LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tracey M Reinecke-kashima | Nurse Practitioner | Charter Internal Medicine, LLC | 2470 Longstone Ln, Suite I, Marriottsville, MD 21104-1523 |
| Jonathan Scott Fish | Internal Medicine | Charter Internal Medicine, LLC | 2470 Longstone Ln, Suite I, Marriottsville, MD 21104-1523 |
| Street Address |
2470 LONGSTONE LN SUITE I |
| City | MARRIOTTSVILLE |
| State | MD |
| Zip | 21104-1523 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeffrey A Torockio | Physical Therapy | 2470 Longstone Ln, Suite K, Marriottsville, MD 21104-1515 | |
| Tracey M Reinecke-kashima | Nurse Practitioner | Charter Internal Medicine, LLC | 2470 Longstone Ln, Suite I, Marriottsville, MD 21104-1523 |
| Jonathan Scott Fish | Internal Medicine | Charter Internal Medicine, LLC | 2470 Longstone Ln, Suite I, Marriottsville, MD 21104-1523 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tavershima Asom | Nurse Practitioner | 7341 Argonne Dr, Marriottsville, MD 21104-1074 | |
| Linda S Crites | Clinical Social Worker | 2838 Hadel Dr, Marriottsville, MD 21104-1187 | |
| Katelyn M Roe | Occupational Therapy | 840 Marriottsville Rd, Marriottsville, MD 21104-1331 | |
| Carolyn Dawn Dockins | Physical Therapy | Unbridled Rehabilitation Services | 840 Marriottsville Rd, Marriottsville, MD 21104-1331 |
| Abigail H Mcnair | Occupational Therapy | Unbridled Rehabilitation Services | 840 Marriottsville Rd, Marriottsville, MD 21104-1331 |
| Risa W Huber | Internal Medicine | Seton Medical Group Inc | 2400 Longstone Ln, Suite 106, Marriottsville, MD 21104-1532 |
| Elizabeth Bower | Internal Medicine | Seton Medical Group Inc | 2400 Longstone Ln, Suite 106, Marriottsville, MD 21104-1532 |
| Ji Yon Kwon | Internal Medicine | Seton Medical Group Inc | 2400 Longstone Ln, Suite 106, Marriottsville, MD 21104-1532 |
| Jonathan R Etter | Ophthalmology | Physicians Eye Care Center LLC | 2400 Longstone Ln, Suite 206, Marriottsville, MD 21104-1533 |
| City | MARRIOTTSVILLE |
| Zip Code | 21104 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | MARRIOTTSVILLE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Randal Paul Riesett.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.