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Individual

AMANDA SUE RIVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D., M.P.H

Contact information

Practice address
133 ROUTE 3, DEDEDO, GU 96929-6911
(671) 645-5500
(671) 645-5549
Mailing address
1433 PALE SAN VITORES ROAD UNIT 707, TAMUNING, GU 96913
(671) 645-5500

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
171188
OR
207P00000X
Emergency Medicine Physician
32158
OK
207P00000X
Emergency Medicine Physician
Primary
M-2039
GU
207P00000X
Emergency Medicine Physician
R73294
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
H109960
GU
Enumeration date
06/17/2012
Last updated
03/17/2018
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