Provider Demographics
NPI:1093806259
Name:FRANK RIVAS MD INC
Entity Type:Organization
Organization Name:FRANK RIVAS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-529-3223
Mailing Address - Street 1:FRANK RIVAS MD INC
Mailing Address - Street 2:PO BOX 9129
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25704
Mailing Address - Country:US
Mailing Address - Phone:304-529-3223
Mailing Address - Fax:304-529-2730
Practice Address - Street 1:1302 FOURTH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25704
Practice Address - Country:US
Practice Address - Phone:304-529-3223
Practice Address - Fax:304-529-2730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12133207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
V002102OtherTRICARE
WV00193067OtherBCBS
WV0083160000Medicaid
OH0421449Medicaid
=========OtherREGULAR INSURACE
V002102OtherTRICARE
=========OtherREGULAR INSURACE
KY1479301Medicare ID - Type Unspecified
WV0083160000Medicaid
OH0421449Medicaid