Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 36003227R | OH |
NPI | 1043283047 |
---|---|
Provider Name | Dr. Dominic Angelo Rizzo |
First Address | Batavia, OH 45103-0322 |
Second Address | Blue Ash, OH 45242-3752 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 03/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000256186 | ANTHEM (01) | OH |
2217925 | (05) | OH |
P00030052 | RR MEDICARE (01) | OH |
U84639 | (02) | OH |