Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 053422 | GA |
NPI | 1114949237 |
---|---|
Provider Name | Monica Rizzo |
First Address | Atlanta, GA 30322-1013 |
Second Address | Atlanta, GA 30322-1013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2387255 | UNITED HEALTHCARE (01) | GA |
3434521 | US HEALTHCARE (01) | GA |
841582 | BCBS (01) | GA |
I02269001 | (02) | GA |
Y 20040401 | PHCS (01) | GA |