MEDICARE: STEPHANOS RIZOS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	01045028	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000721927	OTHER	IN	ANTHEM TRADITIONAL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376515841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANOS RIZOS MD

Provider Business Mailing Address
First Line	:	2915 LAKE SHORE DR
Second Line	:
City	:	LONG BEACH
State	:	IN
Zip	:	46360-1705
Country	:	US
Telephone Number	:	219-879-1133
Fax Number	:

Provider Business Practice Location Address
First Line	:	2915 LAKE SHORE DR
Second Line	:
City	:	LONG BEACH
State	:	IN
Zip	:	46360-1705
Country	:	US
Telephone Number	:	219-879-1133
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	02/16/2026

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Directions to “ STEPHANOS RIZOS MD” Practice Location

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