Individual
MR. SIMON RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13700 ST. FRANCIS BLVD, EMERGENCY MEDICINE DEPARTMENT, MIDLOTHIAN, VA 23114-3267
(804) 594-7950
(804) 594-0489
Mailing address
38935 ANN ARBOR ROAD, CREDENTIALING/PAYER CONTRACTING, LIVONIA, MI 48150-3397
(734) 805-0477
(866) 250-6385
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002952
VA
363A00000X
Physician Assistant
011817
NY
Other
Enumeration date
05/23/2007
Last updated
07/23/2025
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