DR. WANDA RIVERA (NPI# 1073591665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073591665 |
| Entity Type | Individual |
| Full Name | DR. WANDA RIVERA |
| Credential | M.D. |
| Practice Address |
1132 Annapolis Rd Odenton MD 21113 |
| Mailing Address |
9910 Franklin Square Dr # 2110 Baltimore MD 21236-4902 |
| Practice Telephone | 4108741400 |
| Mailing Telephone | 4109335412 |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2018-06-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | D0062879 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | UHC PROVIDER NUMBER | 2610730 | 01 |
| MD | CAREFIRST MD RENDERING | 651290-01 | 01 |
| MD | AETNA FEE FOR SERVICE | 7312772 | 01 |
| MD | CAREFIRST MPOS | P17025 | 01 |
| MD | AETNA CAPITATED | 1172181 | 01 |
| MD | 409667300 | 05 | |
| MD | CAREFIRST BLUECHOICE | 7605-0080 | 01 |
| MD | MAMSI PRIMARY CARE | 8146200 | 01 |
| MD | MAMSI SPECIALIST | 2146200 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1132 Annapolis Rd, Odenton, MD 211131647 | 4108741400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548463516 | Wanda Rivera | Physician Assistant | 3600 Lake Bayshore Dr Unit 502, Bradenton, FL 34205-9050 | 2007-06-07 |
| 1205046976 | Wanda Yadira Rivera | Psychologist | Calle Guarionex #7, Local 2, Hato Rey, PR 00917 | 2007-05-23 |
| 1679537104 | Wanda Acuna Rivera | Dietitian, Registered | 6036 Cedar Ln, Bldg 1277, Hill Afb, UT 84056-5812 | 2006-04-13 |
| 1013201201 | Wanda A Rivera | Pharmacist | 3600 W Nolana Ave, Mcallen, TX 78504-4594 | 2011-06-05 |
| 1083892129 | Wanda Rivera | Physician Assistant | 128 Ashford Ave, Dobbs Ferry, NY 10522-1924 | 2008-01-31 |
| 1063637536 | Wanda Ivelisse Rivera | Pharmacy Technician | St. 152 Cedro Arriba, Km 9.9, Naranjito, PR 00719 | 2007-04-17 |
| 1265550339 | Wanda I Rivera | Pharmacy Technician | 27 Calle Baldorioty, Coamo, PR 00769-3122 | 2007-03-27 |
| 1407982812 | Wanda I Rivera | Optometrist | 59 Ave Esmeralda, Urb Ponce De Leon, Guaynabo, PR 00969-4429 | 2007-02-27 |
| Street Address |
1132 ANNAPOLIS RD |
| City | ODENTON |
| State | MD |
| Zip Code | 21113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811497860 | Justin Marcus Luckadue | Pharmacist | 1132 Annapolis Rd, Odenton, MD 21113-1647 | 2018-02-16 |
| 1053835991 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1132 Annapolis Rd, Odenton, MD 21113-1602 | 2017-08-02 |
| 1588040554 | Michael Baly | Clinical Neuropsychologist | 1132 Annapolis Rd, Suite 200, Odenton, MD 21113-1647 | 2015-07-31 |
| 1588069041 | Sarah Foote | Nurse Practitioner | 1132 Annapolis Rd, Odenton, MD 21113 | 2014-10-27 |
| 1699176149 | Erin Christine Gonzalez | Nurse Practitioner | 1132 Annapolis Rd, Suite 201, Odenton, MD 21113-1647 | 2014-09-15 |
| 1760881494 | Physiotherapy Associates | Clinic/Center | 1132 Annapolis Rd, Suite 101, Odenton, MD 21113-1647 | 2014-08-19 |
| 1346678992 | Ashley Marie Zinalabedini | Nurse Practitioner | 1132 Annapolis Rd, Odenton, MD 21113-1647 | 2013-10-17 |
| 1548531767 | Naomi Rebecca Rios | Pediatrics | 1132 Annapolis Rd, Suite 201, Odenton, MD 21113-1647 | 2012-01-19 |
| 1689958035 | Kimberly Crim | Nurse Practitioner | 1132 Annapolis Rd, Odenton, MD 21113 | 2011-10-04 |
| 1740589100 | Susan Drum | Pharmacist | 1132 Annapolis Rd, Odenton, MD 21113-1647 | 2011-03-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366938599 | Dmv Community Health Services LLC | Clinic/Center | 87778 Pine Orchard Parkway, Odenton, MD 21113 | 2018-07-11 |
| 1285125997 | Edward Lashawn Harvey | Specialist | 207 Ammunition Ave, Odenton, MD 21113 | 2018-05-29 |
| 1275041394 | Aimee Kathleen Olivera Sanchez | Social Worker | 2150 Colonel Way, Odenton, MD 21113 | 2018-01-11 |
| 1891214714 | Bincy Kuttiplackal Mathai | Dentist | 1135 Annapolis Road, Odenton, MD 21113 | 2017-09-12 |
| 1730601949 | Amanda Mary Jackiewicz | Physician Assistant | Greater Maryland Pain Management, 1130 Annapolis Rd Suite 100, Odenton, MD 21113 | 2017-07-10 |
| 1346771235 | Pattrena Reid | Respiratory Therapist, Registered | 115 Bragg Blvd, Odenton, MD 21113 | 2017-03-23 |
| 1225572233 | Pamela Denise Ponder | Internal Medicine | 2603 Portola Court, Odenton, MD 21113 | 2016-12-09 |
| 1285052803 | Diana Nicole Spell | Internal Medicine | Johns Hopkins Community Physicians - Odenton, 1106 Annapolis Road, Odenton, MD 21113 | 2014-04-01 |
| 1730431321 | Orthopedic Physicians of Annapolis LLC | Prosthetic/Orthotic Supplier | 1106 Annapolis Road, Suite 130, Odenton, MD 21113 | 2012-10-08 |
| 1275869463 | Olubukola Fakunle | Pharmacist | 2294 Blue Water Blvd, Weis Pharmacy, Odenton, MD 21113 | 2009-10-23 |
| Find all providers in zip 21113 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285052803 | Diana Nicole Spell | Internal Medicine | Johns Hopkins Community Physicians - Odenton, 1106 Annapolis Road, Odenton, MD 21113 | 2014-04-01 |
| 1164781811 | Jefferson L Hendrickson | Internal Medicine | 1106 Annapolis Rd, Odenton, MD 21113-1637 | 2012-05-15 |
| 1225272677 | Shawna Michelle Reshard | Internal Medicine | 1106 Annapolis Rd Ste 310, Odenton, MD 21113 | 2009-04-29 |
| 1770608721 | Robert Bradley Boughan | Internal Medicine | 1106 Annapolis Rd, Suite 310, Odenton, MD 21113-1602 | 2007-03-20 |
| 1407970353 | Kathryn Strain | Internal Medicine | 1106 Annapolis Rd Ste 310, Odenton, MD 21113 | 2007-03-18 |
| 1508980459 | Mark H. Davino | Internal Medicine | 1106 Annapolis Rd, Suite 310, Odenton, MD 21113-1647 | 2007-03-18 |
| 1811031297 | Michael C. Albert | Internal Medicine | 1106 Annapolis Rd Ste 310, Odenton, MD 21113 | 2007-02-17 |
| 1033264270 | Mollie M Davis | Internal Medicine | 1106 Annapolis Rd Ste 310, Odenton, MD 21113 | 2007-01-25 |
| 1790834299 | Holly Eyler-yeatman | Internal Medicine | 1106 Annapolis Rd, Suite 310, Odenton, MD 21113-1637 | 2007-01-10 |
| 1477643013 | Seema Aliasgar Gadiwalla | Internal Medicine | 1106 Annapolis Rd, Odenton, MD 21113 | 2006-10-13 |
| Find all providers in ODENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.