Individual
RICHARD GIL RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3369 BUFORD HWY NE, SUITE 810, BROOKHAVEN, GA 30329-3722
(404) 321-4692
Mailing address
400 TOWER RD NE STE 200, MARIETTA, GA 30060-9412
(770) 422-1372
(770) 999-2488
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3833
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3833
LICENSE
GA
Enumeration date
04/26/2006
Last updated
10/27/2021
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