Individual
APOLLO S RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2420 LAKE AVE, ASHTABULA, OH 44004-4954
(440) 997-2262
(440) 997-6644
Mailing address
854 TOWNSHIP ROAD 713, ASHLAND, OH 44805-9536
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
35045041
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0529584
—
OH
01
—
942460636151
CARESOURCE
OH
Enumeration date
08/01/2006
Last updated
07/08/2007
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