Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0422724 | KS |
N | 2080P0214X | Pediatric Pulmonologist | 0422724 | KS |
Y | 2080P0214X | Pediatric Pulmonologist | 35438 | SC |
NPI | 1184651564 |
---|---|
Provider Name | Concetta Maria Riva |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-8908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100179590C | (05) | KS |
100179590D | (05) | KS |
105852 | BCBS OF KANSAS (01) | KS |
106582 | BCBS (01) | KS |
E59936 | (02) |