Healthcare Provider Details

I. General information

NPI: 1780370916
Provider Name (Legal Business Name): RUBAB RIZWAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 ADAMS RD
WILLIAMSTOWN MA
01267-2930
US

IV. Provider business mailing address

255 NORTH ST APT 309
PITTSFIELD MA
01201-1867
US

V. Phone/Fax

Practice location:
  • Phone: 413-458-8182
  • Fax:
Mailing address:
  • Phone: 470-979-5214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1027647
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: