Individual provider · Type 1 NPI

Dennis W. Rivenburgh, PHYSICIAN ASSTISTANT

Medical Physician Assistant · Baltimore, MD

NPI number 1669454104 Active

Practice location

5051 Greenspring Ave
Baltimore, MD 21209-4354

Call (410) 601-9515 Map

Fax (410) 601-8905

Mailing address

601 N Caroline St Fl 5
Baltimore, MD 21287-0006

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XPA3490 (FL)
Surgical Physician Assistant 363AS0400XPA3490 (FL)
Medical Physician Assistant Primary 363AM0700XC0004803 (MD)

Medical Physician Assistant: Definition to come...

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About NPI 1669454104

Dennis W. Rivenburgh, PHYSICIAN ASSTISTANT's National Provider Identifier is 1669454104, issued on Nov 18, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Baltimore, MD. The record was last updated on Oct 1, 2018.