Male or Other

Dr. Peter A. Rives MD

Family Medicine Physician in Orange Park, FL(View on Map)

Full Name

Dr. Peter A. Rives MD

NPI Number

1609828110

NPI Type

Individual Provider

Gender

Male

Enumeration Date

05/16/2006

Specialties

(Taxonomies)

Code

207Q00000X
207P00000X
208M00000X

Primary Taxonomy

Yes
No
No

Licenses

State

Florida
Georgia
Kentucky

License Number

ME124964
061646
33705

Contact
Information

Purpose

Mailing
Location

Address

2021 PROFESSIONAL CENTER DRIVE
2021 PROFESSIONAL CENTER DRIVE

City

Orange Park
Orange Park

State

FL
FL

Postal Code

32073-5174
32073-5174

Country

US
US

Telephone Number

(912) 350-8404
(912) 350-8404

Identifiers

Identifier

582162071-014
01230056
479466
631688987A
G61646
P00649638

Identifier State

Unknown
Unknown
GA
GA
SC
GA

Identifier Issuer

HMHS/TRICARE SOUTH
AMERIGROUP
WELLCARE
Unknown
Unknown
RR MEDICARE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/31/2015

Provider Address

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