Provider Demographics
NPI:1629052121
Name:RIVARD, ROBERT G (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:RIVARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5254 BAMBURG CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-2826
Mailing Address - Country:US
Mailing Address - Phone:301-663-1509
Mailing Address - Fax:
Practice Address - Street 1:1425 PORTER ST
Practice Address - Street 2:USMARIID - MED DIVISION
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-9211
Practice Address - Country:US
Practice Address - Phone:301-619-4646
Practice Address - Fax:210-916-2121
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2007-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIMD-11854207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease