Individual
DR. RICHARD NIVALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5623 E DUNBAR RD, MONROE, MI 48161-9127
(734) 241-3891
(734) 241-0014
Mailing address
5623 E DUNBAR RD, MONROE, MI 48161-9127
(734) 241-3891
(734) 241-0014
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301027018
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105191943
—
MI
01
—
CA3050
RAILROAD MEDICARE - GROUP
MI
01
—
P00606310
RAILROAD MEDICARE - INDIV
MI
01
—
RN027018
INITIALS AND LIC #
MI
Enumeration date
07/25/2006
Last updated
10/01/2009
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