Doctor Name: | HUGO RIVERA |
NPI Number: | 1235577511 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | TP13122 |
Business Practice Address: | 15 E Chestnut St Augusta, ME - 043305736 |
Business Phone Number: | 2076261561 |
Business Fax Number: | 2076261849 |
Mailing Address: | 15 E Chestnut St, AUGUSTA |
State: | ME |
Postal Code: | 043305736 |
Phone Number: | 2076261561 |
Fax Number: | 2076261849 |
NPI Enumeration Date: | 06/10/2013 |
NPI Last Update Date: | 03/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | TP13122 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |