Provider Demographics
NPI:1285770347
Name:RIZVI, SYED W (MD)
Entity type:Individual
Prefix:DR
First Name:SYED
Middle Name:W
Last Name:RIZVI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 CHAMPIONS CLOSE
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-0949
Mailing Address - Country:US
Mailing Address - Phone:678-575-0288
Mailing Address - Fax:
Practice Address - Street 1:420 CHARTER BLVD STE 402
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-0722
Practice Address - Country:US
Practice Address - Phone:478-757-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044073207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000756093DMedicaid
GA000756093DMedicaid
GA11SCFBNMedicare ID - Type Unspecified