Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revive Medical Group, PC

Organization Psychiatry Physician · NPI 1033798871

Revive Medical Group, PC is a Psychiatry Physician in Clinton, Missouri. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1600 N 2nd St
Clinton, MO 64735-1192
Phone: (203) 430-1321
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X

Record details

NPI number1033798871
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Omar Ziyadeh — Pc Manager · (203) 430-1321
NPI enumeratedApril 7, 2021
Last updated in NPPESApril 13, 2021
Certification dateApril 13, 2021
Mailing address810 Reef Rd, Fairfield, CT 06824-6538

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