Provider Demographics
NPI:1669636536
Name:RIVA POSSE, PATRICIO (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIO
Middle Name:
Last Name:RIVA POSSE
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 1:1425 ROCK SPRINGS CIR NE
Mailing Address - Street 2:APT 3-1525
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-2228
Mailing Address - Country:US
Mailing Address - Phone:404-934-5721
Mailing Address - Fax:404-727-4746
Practice Address - Street 1:2004 RIDGEWOOD DR NE
Practice Address - Street 2:TUFTS HOUSE SUITE 216
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1031
Practice Address - Country:US
Practice Address - Phone:404-727-5157
Practice Address - Fax:404-727-4746
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA649622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry