Provider Demographics
NPI:1437380276
Name:RIZWAN, MIAN (MD)
Entity type:Individual
Prefix:
First Name:MIAN
Middle Name:
Last Name:RIZWAN
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 1:8776 E SHEA BLVD # 487
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6629
Mailing Address - Country:US
Mailing Address - Phone:480-571-3060
Mailing Address - Fax:480-571-3061
Practice Address - Street 1:14201 N 87TH ST STE A-105
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-3683
Practice Address - Country:US
Practice Address - Phone:480-571-3060
Practice Address - Fax:480-571-3061
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013021418207R00000X, 208M00000X
AZ65678207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1437380276Medicaid
MO991390106Medicare PIN