Individual
EMILIO T. RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5290 MCNUTT RD, STE 109, SANTA TERESA, NM 88008
(575) 589-1144
(575) 589-2008
Mailing address
PO BOX 1590, SANTA TERESA, NM 88008-1590
(575) 589-1144
(575) 589-2008
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
89-285
NM
207Q00000X
Family Medicine Physician
Primary
89-285
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050051043
RR MEDICARE
—
05
—
30858
—
NM
01
—
NM009D02
BCBS OF NM
NM
01
—
NM011595
BCBS NM
NM
Enumeration date
03/08/2006
Last updated
01/31/2025
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