Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | WR054582 | MI |
Y | 207R00000X | Internist | 4301054582 | MI |
Y | 111NI0900X | Internist | 4301054582 | MI |
NPI | 1114931698 |
---|---|
Provider Name | William E Rizzo |
First Address | Clarkston, MI 48346-3198 |
Second Address | Clarkston, MI 48346-3198 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 13/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104467654 | (05) | MI |
F37580 | (02) |