Ismael Hiram Soto Rivas, MD | |
2725 Airview Blvd Ste 105, Portage, MI 49002 | |
(269) 349-8386 | |
(269) 349-8397 |
Full Name | Ismael Hiram Soto Rivas |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 2725 Airview Blvd Ste 105, Portage, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699787556 | NPI | - | NPPES |
21479 SO | Other | TRIPLE-S |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 13373 (Puerto Rico) | Secondary |
207Q00000X | Family Medicine | 4301113708 (Michigan) | Primary |
Entity Name | Vpa Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336153295 PECOS PAC ID: 9234041948 Enrollment ID: O20031103000102 |
Mailing Address | Practice Location Address |
---|---|
Ismael Hiram Soto Rivas, MD 2725 Airview Blvd Ste 105, Portage, MI 49002-1804 Ph: (269) 349-8386 | Ismael Hiram Soto Rivas, MD 2725 Airview Blvd Ste 105, Portage, MI 49002 Ph: (269) 349-8386 |
Brandon J Manderle, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 2700 E Centre Ave, Portage, MI 49002 Phone: 269-286-7050 | |
Carolyn Von Maur, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7901 Angling Road, Suite B-201, Portage, MI 49024 Phone: 269-324-8600 | |
Remnant Mwanahiba, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2700 E Centre Ave, Portage, MI 49002 Phone: 269-286-7050 | |
Dr. Ann M. Busha, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 3300 W Centre Ave, Portage, MI 49024 Phone: 269-324-8950 Fax: 269-324-2134 | |
Amber Darey, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3300 W Centre Ave, Portage, MI 49024 Phone: 269-324-8950 Fax: 269-324-2134 | |
Lawrence Ulmer, Family Medicine Medicare: Medicare Enrolled Practice Location: 7901 Angling Rd, Suite B-201, Portage, MI 49024 Phone: 269-324-8600 Fax: 269-324-8617 | |
Dr. Miriam Yvonne Veldt, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2725 Airview Blvd, Suite 105, Portage, MI 49002 Phone: 269-349-8386 Fax: 269-349-8397 |