Provider Demographics
NPI:1275718793
Name:RIZVI, NESSREEN SOBH (MD)
Entity Type:Individual
Prefix:DR
First Name:NESSREEN
Middle Name:SOBH
Last Name:RIZVI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11650 BELLEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-3380
Mailing Address - Country:US
Mailing Address - Phone:586-596-9385
Mailing Address - Fax:
Practice Address - Street 1:11650 BELLEVILLE RD
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-3380
Practice Address - Country:US
Practice Address - Phone:734-699-9888
Practice Address - Fax:734-293-1774
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301097600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301097600OtherSTATE LICENSE #
MI1275718793OtherBCBS TYPE 1 (IND) NPI #
MI5315047914OtherCDS #