Individual
DR. GLENN SCOTT RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(415) 827-8390
Mailing address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(415) 827-8390
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
1168
—
Other
Enumeration date
03/19/2019
Last updated
03/19/2019
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