Provider Demographics
NPI:1295293280
Name:GARCIA RIVERA, MIRIAN VANESA (MD)
Entity type:Individual
Prefix:
First Name:MIRIAN
Middle Name:VANESA
Last Name:GARCIA RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 TYSON RD
Mailing Address - Street 2:
Mailing Address - City:PROCTORSVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05153-9669
Mailing Address - Country:US
Mailing Address - Phone:603-667-5196
Mailing Address - Fax:
Practice Address - Street 1:SENTARA INFECTIOUS DISEASE SPECIALISTS
Practice Address - Street 2:850 KEMPSVILLE RD STE 100F
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-261-5963
Practice Address - Fax:757-275-9940
Is Sole Proprietor?:No
Enumeration Date:2019-03-08
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program