Individual
RICARDO A NIEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1437 RIVERSIDE AVE, FORT COLLINS, CO 80524-4324
(970) 692-5550
(970) 692-5561
Mailing address
1437 RIVERSIDE AVE, FORT COLLINS, CO 80524-4324
(970) 692-5550
(970) 692-5561
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
40977
CO
208VP0014X
Interventional Pain Medicine Physician
2000325
NM
208VP0014X
Interventional Pain Medicine Physician
Primary
40977
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04732863
—
CO
05
—
B9615
—
NM
Enumeration date
10/02/2006
Last updated
11/16/2012
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