Provider Demographics
NPI:1770650210
Name:BIZO, MARIA K (CNM)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:K
Last Name:BIZO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:JEREMIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 WALNUT ST FL 14
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5176
Mailing Address - Country:US
Mailing Address - Phone:215-829-8000
Mailing Address - Fax:215-829-8623
Practice Address - Street 1:800 WALNUT ST FL 14
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5176
Practice Address - Country:US
Practice Address - Phone:215-829-8000
Practice Address - Fax:215-829-8623
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009740176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q30830Medicare UPIN
42BBBRHMedicare ID - Type Unspecified