Individual
DR. EMANUEL RIVERA ROSADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1580 FREEDOM BLVD STE 100, FLORENCE, SC 29505-6074
(843) 413-6835
(843) 661-2194
Mailing address
PO BOX 603898, CHARLOTTE, NC 28260-3898
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101263695
VA
207X00000X
Orthopaedic Surgery Physician
Primary
82309
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578901039
MEDICARE
VA
05
—
1578901039
—
VA
Enumeration date
06/06/2013
Last updated
10/22/2020
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