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Individual

MANUEL A. RIVERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4536 22ND AVE, KENOSHA, WI 53140-5917
(262) 656-0044
(262) 653-2218
Mailing address
4006 WASHINGTON RD, KENOSHA, WI 53144-4819
(262) 656-0044
(262) 653-2218

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
H0762
TX
207R00000X
Internal Medicine Physician
Primary
26699
WI

Other

Enumeration date
02/28/2006
Last updated
06/30/2023
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