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Contact Information

RIVER VALLEY MEDICAL GROUP, LLC
4626 PROGRESS DR STE C
DAVENPORT, IA52807-3485
 Phone: 563-551-4200
 Fax: 563-441-9101
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for RIVER VALLEY MEDICAL GROUP LLC · (Female)

NPI Number 1396408290
Status Active
Credentials
Entity Individual
Enumeration date 10/18/2021
Last updated 06/23/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers
  • IA Medicaid 1598744096
  • Other G81285 MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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