Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 125053960 | IL |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 5101017418 | MI |
Y | 2081P2900X | Pain Medicine | A-1668-12 | NM |
NPI | 1245418490 |
---|---|
Provider Name | William Rivers |
First Address | Albuquerque, NM 87106-4374 |
Second Address | Albuquerque, NM 87131-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2008 |
Last Update Date | 22/03/2017 |