Provider Demographics
NPI:1164507679
Name:RIZVI, RUKHSANA (MD)
Entity Type:Individual
Prefix:
First Name:RUKHSANA
Middle Name:
Last Name:RIZVI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RUKHSANA
Other - Middle Name:
Other - Last Name:RIZVI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1902 MACY DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-6339
Mailing Address - Country:US
Mailing Address - Phone:770-837-9710
Mailing Address - Fax:678-205-5131
Practice Address - Street 1:1902 MACY DRIVE
Practice Address - Street 2:ATLANTA PSYCHIATRIC MEDICINE INC
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076
Practice Address - Country:US
Practice Address - Phone:678-795-0346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0553302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H79355Medicare UPIN
GA26DBJWBMedicare ID - Type Unspecified