Provider Demographics
NPI:1457820136
Name:RIZWAN, MOHAMMAD (DC)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:
Last Name:RIZWAN
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13317 JARIST CT
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:VA
Mailing Address - Zip Code:20124-0976
Mailing Address - Country:US
Mailing Address - Phone:703-507-2537
Mailing Address - Fax:
Practice Address - Street 1:95 DUNN DR STE 123
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-1503
Practice Address - Country:US
Practice Address - Phone:703-523-9565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-25
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104-557525111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
-Other-