| Doctor Name: | CARLOS A RIVAS |
| NPI Number: | 1942261052 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | R4668 |
| Business Practice Address: | 3065 William St Suite 209 Cape Girardeau, MO - 637036393 |
| Business Phone Number: | 5733354100 |
| Business Fax Number: | 5733397887 |
| Mailing Address: | 3065 William St, Suite 209 CAPE GIRARDEAU |
| State: | MO |
| Postal Code: | 637036393 |
| Phone Number: | 5733354100 |
| Fax Number: | 5733397887 |
| NPI Enumeration Date: | 03/29/2006 |
| NPI Last Update Date: | 11/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | R4668 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |