Provider Demographics
NPI:1063632990
Name:RIVET, EMILY BURKE (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:BURKE
Last Name:RIVET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:BURKE
Other - Last Name:DISKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 780126
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178
Mailing Address - Country:US
Mailing Address - Phone:804-922-4844
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:DEPT. OF SURGERY/BARIATRIC & GASTROINTESTINAL
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:804-327-8001
Practice Address - Fax:804-327-8002
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101243401208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1063632990Medicaid
VAGC1014Medicare PIN
VAMC11130Medicare PIN