Individual
MR. MELANIO AYHON RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
CG II MEF, CAMP LEJEUNE, NC 28542
(910) 451-0451
Mailing address
211 MARINE DR, N TOPSAIL BEACH, NC 28460-6778
(910) 327-0636
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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