Provider Demographics
NPI:1932198116
Name:RIFKIN, MICHAEL HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HOWARD
Last Name:RIFKIN
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 1:6914 GREENVALE CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-2925
Mailing Address - Country:US
Mailing Address - Phone:301-401-6890
Mailing Address - Fax:301-694-2728
Practice Address - Street 1:6914 GREENVALE CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-2925
Practice Address - Country:US
Practice Address - Phone:301-401-6890
Practice Address - Fax:301-694-2728
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0043025207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD258100100Medicaid
MD413697OtherMAMSI
MD52-2111986OtherUNITED HEALTHCARE
MD533144-03OtherCAREFIRST BLUE CROSS
F91804Medicare UPIN
MD533144-03OtherCAREFIRST BLUE CROSS