Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207ND0101X | MOHS-Micrographic Surgeon | 2007022070 | MO |
N | 207ND0101X | MOHS-Micrographic Surgeon | 4181 | IA |
Y | 207ND0101X | MOHS-Micrographic Surgeon | DO987 | AL |
N | 207R00000X | Internist | OS9692 | FL |
N | 111NI0900X | Internist | OS9692 | FL |
NPI | 1366583882 |
---|---|
Provider Name | Dr. Albert Earl Rivera |
First Address | Madison, AL 35758-2070 |
Second Address | Madison, AL 35758-2070 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 27/07/2012 |