Individual
DR. JORGE R RIVERA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3638 VERONA TRL, ROANOKE, VA 24018-4919
(540) 772-2776
Mailing address
3638 VERONA TRL, ROANOKE, VA 24018-4919
(540) 772-2776
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101248583
VA
207R00000X
Internal Medicine Physician
MD441893
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025751630001
—
PA
Enumeration date
06/08/2007
Last updated
03/24/2017
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