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General NPI Number Information
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NPI Number | 1851591044
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Entity Type | Individual
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Provider Name | ERICK F RIVAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 288 PEACE BLVD
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-9562
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Country | US
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Telephone | 517-273-1540
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Fax |
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Provider Business Mailing Address
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Address Line | 4 E OGDEN AVE UNIT 348
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City | WESTMONT
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State | IL
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Zip | 60559-3506
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Country | US
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Telephone | 517-273-1540
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Fax | 517-827-4909
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301090493
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036141982
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301090493
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036141982
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 01072759A
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License Number State | IN
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