Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 51819 | SC |
N | 208200000X | Surgeon | 51819 | SC |
N | 208600000X | Surgeon | 51819 | SC |
NPI | 1841515996 |
---|---|
Provider Name | Dr. Mariangela Rivera |
First Address | Greenville, SC 29601-2842 |
Second Address | Greenville, SC 29615-6306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2010 |
Last Update Date | 28/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
518194 | (05) | SC |