Provider Demographics
NPI:1114198348
Name:TARIQ RIZVI, SAYED (MD)
Entity Type:Individual
Prefix:
First Name:SAYED
Middle Name:
Last Name:TARIQ RIZVI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SAYED
Other - Middle Name:
Other - Last Name:TARIQ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:100 W MCCREIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1885
Mailing Address - Country:US
Mailing Address - Phone:937-323-1404
Mailing Address - Fax:937-523-9555
Practice Address - Street 1:100 W MCCREIGHT AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1885
Practice Address - Country:US
Practice Address - Phone:937-323-1404
Practice Address - Fax:937-523-9555
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-15
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003076208M00000X
390200000X
OH35.128265207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program