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Individual

SIEN SUSUMU-RAFAEL RIVERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3555 HARDEN STREET EXT STE 141, COLUMBIA, SC 29203-6894
(803) 434-4300
(803) 434-4351
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
LL41040
SC
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
41040
SC

Other

Enumeration date
06/29/2017
Last updated
07/27/2022
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