Provider Demographics
NPI:1659463891
Name:AARON B RIVES, DPM PC
Entity Type:Organization
Organization Name:AARON B RIVES, DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:RIVES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:734-479-1410
Mailing Address - Street 1:14500 KING RD
Mailing Address - Street 2:STE 2
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-7957
Mailing Address - Country:US
Mailing Address - Phone:734-479-1410
Mailing Address - Fax:734-479-4484
Practice Address - Street 1:14500 KING RD
Practice Address - Street 2:STE 2
Practice Address - City:RIVERVIEW
Practice Address - State:MI
Practice Address - Zip Code:48193-7957
Practice Address - Country:US
Practice Address - Phone:734-479-1410
Practice Address - Fax:734-479-4484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M74760Medicare ID - Type Unspecified
MI1308320001Medicare NSC