Individual
FERNANDO A RIVERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6140 W CURTISIAN AVE STE 100, BOISE, ID 83704-0109
(208) 302-0130
(208) 302-0135
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
37552
WI
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MC-0427
ID
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD60930244
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2127756
—
WA
05
—
32205400
—
WI
Enumeration date
07/06/2006
Last updated
07/22/2024
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