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General NPI Number Information
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NPI Number | 1942595228
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Entity Type | Individual
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Provider Name | SHAYNA COLLEEN RIVARD MD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 55 MILL ST
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City | WOLFEBORO
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State | NH
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Zip | 03894-4328
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Country | US
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Telephone | 603-569-3376
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Fax | 603-569-5046
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Provider Business Mailing Address
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Address Line | ADULT & PEDIATRIC DERMATOLOGY, PC 55 MILL STREET
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City | WOLFEBORO
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State | NH
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Zip | 03894
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Country | US
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Telephone | 603-626-7546
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Fax | 603-569-5046
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 22256
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 0101252746
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | T6024
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD0000064760
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME144349
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 22256
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License Number State | NH
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