Healthcare Provider Details
I. General information
NPI: 1629916986
Provider Name (Legal Business Name): RIVKIN ADDICTION MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/24/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19100 GODDARD RD STE 1
ALLEN PARK MI
48101-1156
US
IV. Provider business mailing address
19100 GODDARD RD STE 1
ALLEN PARK MI
48101-1156
US
V. Phone/Fax
- Phone: 348-330-2954
- Fax:
- Phone: 313-315-6922
- Fax: 313-315-6922
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AARON
MATTHEW
RIVKIN
Title or Position: OWNER, SOLE OPERATOR
Credential: MD
Phone: 248-330-2954