Healthcare Provider Details

I. General information

NPI: 1659463891
Provider Name (Legal Business Name): AARON B RIVES, DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4969 DRIFTWOOD DR STE 2
COMMERCE TOWNSHIP MI
48382-1368
US

IV. Provider business mailing address

4969 DRIFTWOOD DR STE 2
COMMERCE TOWNSHIP MI
48382-1368
US

V. Phone/Fax

Practice location:
  • Phone: 734-479-1410
  • Fax: 734-479-4484
Mailing address:
  • Phone: 734-479-1410
  • Fax: 734-479-4484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW KOO-SUNG-MIN BROWN
Title or Position: PRESIDENT
Credential: DPM
Phone: 734-479-1410