Individual
CARLOS A RIVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3065 WILLIAM ST, SUITE 209, CAPE GIRARDEAU, MO 63703-6393
(573) 335-4100
(573) 339-7887
Mailing address
3065 WILLIAM ST, SUITE 209, CAPE GIRARDEAU, MO 63703-6393
(573) 335-4100
(573) 339-7887
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
2010011993
MO
208D00000X
General Practice Physician
R4668
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942261052
—
MO
Enumeration date
03/29/2006
Last updated
10/07/2020
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