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Individual

DR. SYED MOHSAN RIZVI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2235 CLEVELAND RD, SOUTH BEND, IN 46628-3529
(574) 647-4530
(574) 647-2285
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01072465A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000831429
BCBS BMG SCHWARTZ-WIEKAMP
IN
01
000000856151
BCBS BMG LAPORTE
IN
01
000000857581
BCBS BMG GOSHEN
IN
01
000000884798
BCBS BMG ELKHART EAST
IN
01
169380076
MEDICARE PTAN
IN
05
201162730
IN
01
P01371333
RR MEDICARE
IN
Enumeration date
01/25/2006
Last updated
05/01/2023
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