Provider Demographics
NPI:1245385319
Name:RIZZARDI, BARBARA EVE (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:EVE
Last Name:RIZZARDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 E 9400 S
Mailing Address - Street 2:#208
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-2957
Mailing Address - Country:US
Mailing Address - Phone:801-576-8333
Mailing Address - Fax:
Practice Address - Street 1:1434 E 9400 S
Practice Address - Street 2:#208
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84093-2957
Practice Address - Country:US
Practice Address - Phone:801-576-8333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT168256207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTC63616Medicare UPIN