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General NPI Number Information
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NPI Number | 1013413541
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Entity Type | Individual
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Provider Name | BRIEANNA BRIENEE BIVENS MD
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Gender | Female
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 4755 OGLETOWN STANTON ROAD SUITE 5A43
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City | NEWARK
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State | DE
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Zip | 19718-2200
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Country | US
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Telephone | 302-623-0188
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Fax | 302-733-5640
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Provider Business Mailing Address
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Address Line | 11 UPPER RIVERDALE RD SW
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City | RIVERDALE
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State | GA
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Zip | 30274-2615
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | D0100368
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | C1-0027117
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 89195
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C1-0027117
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License Number State | DE
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0100368
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License Number State | MD
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