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Individual

DR. MATTHEW BRIAN RIVENBURGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 MEDICAL CENTER DRIVE, SLIDELL, LA 70461-5520
(985) 646-5189
Mailing address
1514 JEFFERSON HIGHWAY, NEW ORLEANS, LA 70121-2429
(504) 842-4000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD.204730
LA
207P00000X
Emergency Medicine Physician
MT190159
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04420828
MS
05
2154401
LA
Enumeration date
07/28/2007
Last updated
11/16/2011
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