# FERNANDO H. RIVERA M.D. INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316118276
- **Authorized official:** FERNANDO H RIVERA M.D. (PRESIDENT)
- **Authorized official phone:** (219) 962-1418

## Contact information

- **Practice address:** 3099 CENTRAL AVE, LAKE STATION, IN 46405-2207
- **Practice address phone:** (219) 962-1418
- **Practice address fax:** (219) 962-4516
- **Mailing address:** 3099 CENTRAL AVE, LAKE STATION, IN 46405-2207
- **Mailing address phone:** (219) 962-1418
- **Mailing address fax:** (219) 962-4516

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01027425A | IN | Yes |

## Other

- **Enumeration date:** 03/19/2008
- **Last updated:** 03/19/2008