Provider Demographics
NPI:1811583982
Name:RIZVI, SAMI A (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMI
Middle Name:A
Last Name:RIZVI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6271 GREEN FIELD RD # D-L3
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6263
Mailing Address - Country:US
Mailing Address - Phone:301-852-3768
Mailing Address - Fax:
Practice Address - Street 1:6271 GREEN FIELD RD # D-L3
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6263
Practice Address - Country:US
Practice Address - Phone:301-852-3768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJDCATEMP-033509208D00000X
INCV2005333208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
INCV2005333OtherINDIANA LICENSE
NJNJDCATEMP-033509OtherNJ :LICENSE