Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 254203 | MA |
N | 207X00000X | Orthopaedic Surgeon | 25MA09473100 | NJ |
Y | 207X00000X | Orthopaedic Surgeon | MD443430 | PA |
N | 207X00000X | Orthopaedic Surgeon | MT192719 | PA |
N | 207XS0106X | Orthopaedic Hand Surgeon | MT192719 | PA |
NPI | 1245403013 |
---|---|
Provider Name | Mr. Michael Rivlin |
First Address | Philadelphia, PA 19107-4414 |
Second Address | Philadelphia, PA 19107-4216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2008 |
Last Update Date | 10/11/2015 |