Provider Demographics
NPI:1992036537
Name:RIYAZ, RIZWAN (MD)
Entity Type:Individual
Prefix:
First Name:RIZWAN
Middle Name:
Last Name:RIYAZ
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 1:3450 MILLER DR
Mailing Address - Street 2:APPARTMENT #1228
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-2726
Mailing Address - Country:US
Mailing Address - Phone:678-510-9236
Mailing Address - Fax:404-230-8967
Practice Address - Street 1:50 HURT PLZ SE STE 600
Practice Address - Street 2:GEORGIA POISON CENTER
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-2915
Practice Address - Country:US
Practice Address - Phone:678-510-9236
Practice Address - Fax:404-230-8967
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA3980207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine