Healthcare Provider Details

I. General information

NPI: 1144421520
Provider Name (Legal Business Name): MARIA RIVAS MD, FACP, FACE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA DEL CARMEN RIVAS-AGUILERA M.D.

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 10/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4631 HICKORY CT
ZIONSVILLE IN
46077-9424
US

IV. Provider business mailing address

4631 HICKORY CT
ZIONSVILLE IN
46077-9424
US

V. Phone/Fax

Practice location:
  • Phone: 317-873-5012
  • Fax:
Mailing address:
  • Phone: 317-873-5012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number11459
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number184639
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: