Gregory J Rivenbark, CAA
Anesthesiologist Assistant in Painesville, OH. Individual provider (NPI-1).
NPI number1164089306
StatusActive
Last updated in NPPESApr 8, 2020
Details
- NPI
- 1164089306
- Entity type
- Individual (NPI-1)
- Name
- Mr. Gregory J Rivenbark
- Credential
- CAA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 23, 2019
- Certification date
- Apr 8, 2020
- Last updated
- Apr 8, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367H00000X | Anesthesiologist Assistant | 67000350 | OH | Yes |
Practice location
7757 Auburn Rd Ste 15Painesville, OH 44077-9604
Phone 440-350-0832
Mailing address
7757 Auburn Rd Ste 15Painesville, OH 44077-9604
Phone 440-350-0832
Other practice locations
7590 Auburn Rd
Painesville, OH 44077-9176
Painesville, OH 44077-9176
Phone 440-350-0832 · Fax 440-579-0191
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