Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 4301063815 | MI |
NPI | 1023170388 |
---|---|
Provider Name | Dr. Wilfredo Rivera |
First Address | Flint, MI 48532-5497 |
Second Address | Flint, MI 48532-5497 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 03/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
060B1089 | BLUE CROSS (01) | |
0B56351 | HEALTH PLUS (01) | |
103420840 | (05) | MI |
383380710 | TRICARE (01) | |
C2810 | M-CARE (01) | |
CN9425 | MEDICARE RAILROAD (01) | |
F81583 | (02) | |
F81583 | HAP (01) |