Individual
CARLOS A RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7505 WATERS AVE, STE C8, SAVANNAH, GA 31406-3825
(912) 352-2606
(912) 352-0623
Mailing address
7505 WATERS AVE, STE C8, SAVANNAH, GA 31406-3825
(912) 352-2606
(912) 352-0623
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
34456
GA
2085N0700X
Neuroradiology Physician
34456
GA
2085N0904X
Nuclear Radiology Physician
34456
GA
2085P0229X
Pediatric Radiology Physician
34456
GA
2085R0202X
Diagnostic Radiology Physician
Primary
34456
GA
2085R0203X
Therapeutic Radiology Physician
34456
GA
2085R0204X
Vascular & Interventional Radiology Physician
34456
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00469169A
—
GA
01
—
024372
BLUE CROSS
GA
05
—
G34456
—
SC
Enumeration date
09/07/2005
Last updated
02/12/2021
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