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NPI Code Detail

MEDICARE: NADRA RIZKALLA M.D.

MEDICARE: NADRA RIZKALLA M.D.
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
1207L00000XAnesthesiology Physician44825MA

General Provider Information

NPI Number : 1760537674
Entity Type Code : Individual
Provider Name (Legal Business Name) : NADRA RIZKALLA M.D.
Provider Business Mailing Address
First Line : PO BOX 1747
Second Line :
City : DUXBURY
State : MA
Zip : 02331-1747
Country : US
Telephone Number : 781-934-6914
Fax Number :
Provider Business Practice Location Address
First Line : 696 MAIN ST
Second Line :
City : WEYMOUTH
State : MA
Zip : 02190-1842
Country : US
Telephone Number : 781-331-3820
Fax Number : 781-331-1076
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2007
Last Update Date : 07/08/2007

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