Individual
PATRICK RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3901 ATRISCO DR NW, PMG ATRISCO, ALBUQUERQUE, NM 87120-1627
(505) 462-7575
(505) 462-7587
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
86320
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4911
—
NM
Enumeration date
10/03/2006
Last updated
03/24/2016
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