Provider Demographics
NPI:1407507429
Name:RIVERA, ISAIAH (MD)
Entity Type:Individual
Prefix:
First Name:ISAIAH
Middle Name:
Last Name:RIVERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37236-4400
Mailing Address - Country:US
Mailing Address - Phone:615-284-3387
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF TENNESSEE 920 MADISON AVENUE SUITE 447
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-1020
Practice Address - Country:US
Practice Address - Phone:615-284-3387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program