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Individual

DR. IAN MATTHEW RIVERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-7665
(706) 787-2326
Mailing address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-7665
(706) 787-2326

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
61853
GA
207RN0300X
Nephrology Physician
Primary
61853
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1780830331
NPI
Enumeration date
08/14/2008
Last updated
03/12/2026
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