Rivera, Lisa Bazemore

Rivera, Lisa Bazemore is an individual health care provider with primary practice located at 3650 Steve Reynolds Blvd Kaiser Permanente Gwinnett Medical Center, Duluth GA 30096-4506. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Rivera, Lisa Bazemore can be contacted via phone (205) 934-4794.

Contact Information

Primary practice address
3650 Steve Reynolds Blvd Kaiser Permanente Gwinnett Medical Center Duluth GA 30096-4506
Phone: (205) 934-4794
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 068548 Georgia

Profile Details

NPI number 1730332131
LBN Legal business name Rivera, Lisa Bazemore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 29th, 2008
Last updated Jan 10th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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