Healthcare Provider Details

I. General information

NPI: 1356015978
Provider Name (Legal Business Name): DR. RIVES FAMILY FOOT CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2021
Last Update Date: 08/06/2021
Certification Date: 08/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28740 APPLEBLOSSOM LN
FARMINGTON HILLS MI
48331-2411
US

IV. Provider business mailing address

28740 APPLEBLOSSOM LN
FARMINGTON HILLS MI
48331-2411
US

V. Phone/Fax

Practice location:
  • Phone: 734-516-6320
  • Fax: 734-479-4484
Mailing address:
  • Phone: 734-516-6320
  • 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: DR. AARON BARRY RIVES
Title or Position: PODIATRIC PHYSICIAN AND SURGEON
Credential: DPM
Phone: 734-516-6320