Provider Demographics
NPI:1063497733
Name:RIZK, PHILIP HIKMAT (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:HIKMAT
Last Name:RIZK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4050 INNSLAKE DR
Mailing Address - Street 2:SUITE 308
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3327
Mailing Address - Country:US
Mailing Address - Phone:804-521-5315
Mailing Address - Fax:804-521-5312
Practice Address - Street 1:1602 SKIPWITH RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5205
Practice Address - Country:US
Practice Address - Phone:804-288-0399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046684207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA302011OtherANTHEM
VA110134511OtherMEDICARE RR
VA6020950Medicaid
VA139783OtherANTHEM BCBS
VA1798699OtherCIGNA
VA631593OtherSOUTHERN HEALTH
VA1063497733Medicaid
VAP00601100OtherMEDICARE RAILROAD
VA6020950Medicaid
VAP00601100OtherMEDICARE RAILROAD
VA00X512C04Medicare PIN
VA006363C88Medicare PIN