Individual
DR. JAIME ALFREDO RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 ENDICOTT ST, SUITE 200, DANVERS, MA 01923-3623
(978) 882-6868
(978) 882-6855
Mailing address
104 ENDICOTT ST, SUITE 200, DANVERS, MA 01923-3623
(978) 882-6868
(978) 882-6855
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
80029
MA
2086S0102X
Surgical Critical Care Physician
80029
MD
2086S0120X
Pediatric Surgery Physician
80029
MA
2086S0127X
Trauma Surgery Physician
80029
MA
2086X0206X
Surgical Oncology Physician
80029
MA
208C00000X
Colon & Rectal Surgery Physician
80029
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042530297
COMMERICAL
MA
01
—
080029
TUFTS
MA
05
—
3175219
—
MA
01
—
RIJ18515
BLUE CROSS BLUE SHIELD
MA
Enumeration date
03/24/2006
Last updated
05/18/2012
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