Provider Demographics
NPI:1972946549
Name:RIVAS RAMIREZ, LISBI DEL VALLE (MD)
Entity Type:Individual
Prefix:
First Name:LISBI
Middle Name:DEL VALLE
Last Name:RIVAS RAMIREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:
Practice Address - Street 1:6420 ROCKLEDGE DR STE 4100
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-7847
Practice Address - Country:US
Practice Address - Phone:240-762-5130
Practice Address - Fax:410-367-2751
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD938652086S0102X
DCMTL001844208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care