Organization
L. C. RIVERA, M.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUZVIMINDA C RIVERA M.D. (PRESIDENT)
(313) 386-8330
Entity
Organization
Contact information
Practice address
26190 OUTER DR, LINCOLN PARK, MI 48146-2084
(313) 386-8330
(313) 388-5667
Mailing address
26190 OUTER DR, LINCOLN PARK, MI 48146-2084
(313) 386-8330
(313) 388-5667
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301033619
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2604745 TYPE 10
—
MI
Enumeration date
01/14/2010
Last updated
01/14/2010
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