Individual
DR. ERNESTO RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3700 FLEET ST, STE 200, BALTIMORE, MD 21224-4200
(410) 558-4900
(410) 522-5070
Mailing address
3501 SINCLAIR LN, BALTIMORE, MD 21213-2029
(410) 732-8800
(410) 534-2392
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
D18554
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07124
AMERIGROUP
—
05
—
118131900
—
MD
01
—
21536
MDIPA
—
01
—
6774E
CAREFIRST BLUE SHIELD MD
MD
01
—
W1050001
BLUE CHOICE
—
Enumeration date
09/08/2005
Last updated
11/09/2015
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