Organization
FERNANDO H. RIVERA M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO H RIVERA M.D. (PRESIDENT)
(219) 962-1418
Entity
Organization
Contact information
Practice address
3099 CENTRAL AVE, LAKE STATION, IN 46405-2207
(219) 962-1418
(219) 962-4516
Mailing address
3099 CENTRAL AVE, LAKE STATION, IN 46405-2207
(219) 962-1418
(219) 962-4516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01027425A
IN
Other
Enumeration date
03/19/2008
Last updated
03/19/2008
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