Provider Demographics
NPI:1891924866
Name:RIVERA, ERIK X (MD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:X
Last Name:RIVERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13415 CONNECTICUT AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ASPEN HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2910
Mailing Address - Country:US
Mailing Address - Phone:301-557-1950
Mailing Address - Fax:301-557-1949
Practice Address - Street 1:13975 CONNECTICUT AVE
Practice Address - Street 2:2ND FLOOR, HOLY CROSS HEALTH CENTER - ASPEN HILL
Practice Address - City:ASPEN HILL
Practice Address - State:MD
Practice Address - Zip Code:20906-2921
Practice Address - Country:US
Practice Address - Phone:301-557-1950
Practice Address - Fax:301-557-1949
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD81294207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD81294OtherMARYLAND BOARD OF PHYSICIANS