Provider Demographics
NPI:1609891753
Name:RIZK, MAGED M (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:MAGED
Middle Name:M
Last Name:RIZK
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 BENDING CT
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-3019
Mailing Address - Country:US
Mailing Address - Phone:810-867-4883
Mailing Address - Fax:810-867-4883
Practice Address - Street 1:754 BENDING CT
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-3019
Practice Address - Country:US
Practice Address - Phone:810-867-4883
Practice Address - Fax:810-867-4883
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301078844207RI0011X
OH35-094037207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4320287Medicaid
OH4267371Medicare PIN
MI4320287Medicaid
MIH28794Medicare UPIN