Provider Demographics
NPI:1598893596
Name:RIVERS, BRUCE ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ANTHONY
Last Name:RIVERS
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 1:7014 OREGON AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1422
Mailing Address - Country:US
Mailing Address - Phone:301-485-9533
Mailing Address - Fax:
Practice Address - Street 1:120 WATERFRONT ST
Practice Address - Street 2:STE 300
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-1142
Practice Address - Country:US
Practice Address - Phone:301-485-9533
Practice Address - Fax:301-691-5261
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064536207W00000X
MDD64536208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice