Rivera, Ian Matthew
Rivera, Ian Matthew is an sole proprietor health care provider with primary practice located at 300 E. Hospital Road Room 8A-30 (Mchf-M-Ne), Fort Gordon GA 30905. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Rivera, Ian Matthew can be contacted via phone (706) 787-7665.Contact Information
Primary practice address
300 E. Hospital Road Room 8A-30 (Mchf-M-Ne)
Fort Gordon GA 30905
Phone: (706) 787-7665
Fax: (706) 787-2326
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 61853 | Georgia |
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 61853 | Georgia |
Profile Details
| NPI number | 1780830331 |
|---|---|
| LBN Legal business name | Rivera, Ian Matthew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 14th, 2008 |
| Last updated | May 12th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780830331 | NPPES |
| Other | 1780830331 | NPI |
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