Individual
DR. JULIO C. RIVERA-ILARRAZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13065 MILLS CREEK DR, LUSBY, MD 20657-5703
(410) 394-0324
(410) 394-6645
Mailing address
PO BOX 1890, LUSBY, MD 20657-6890
(410) 394-0324
(410) 394-6645
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
002554
PR
2083X0100X
Occupational Medicine Physician
0101030636
VA
2083X0100X
Occupational Medicine Physician
Primary
D0023153
MD
2083X0100X
Occupational Medicine Physician
MD11081
DC
Other
Enumeration date
11/11/2010
Last updated
11/12/2010
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