Individual
CONCETTA MARIA RIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0422724
KS
2080P0214X
Pediatric Pulmonology Physician
0422724
KS
2080P0214X
Pediatric Pulmonology Physician
Primary
35438
SC
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
35438
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100179590C
—
KS
05
—
100179590D
—
KS
01
—
105852
BCBS OF KANSAS
KS
01
—
106582
BCBS
KS
Enumeration date
06/28/2006
Last updated
10/15/2020
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