| Fernando H. Rivera M.d. Inc | |
|
3099 Central Ave Lake Station IN 46405-2207 | |
| (219) 962-1418 | |
| (219) 962-4516 |
| Full Name | Fernando H. Rivera M.d. Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 3099 Central Ave, Lake Station, Indiana |
| Authorized Official Name and Position | Fernando H Rivera (PRESIDENT) |
| Authorized Official Contact | 2199621418 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fernando H. Rivera M.d. Inc 3099 Central Ave Lake Station IN 46405-2207 Ph: (219) 962-1418 | Fernando H. Rivera M.d. Inc 3099 Central Ave Lake Station IN 46405-2207 Ph: (219) 962-1418 |
| NPI Number | 1316118276 |
|---|---|
| Provider Enumeration Date | 03/19/2008 |
| Last Update Date | 03/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316118276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01027425A (Indiana) | Primary |
Northshore Health Centers, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3304 Parkside Ave, Lake Station, IN 46405 Phone: 219-763-8112 Fax: 219-962-1860 |