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General NPI Number Information
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NPI Number | 1700107349
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Entity Type | Individual
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Provider Name | FAWAD H RIZVI D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2010
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 23800 ORCHARD LAKE RD STE 200
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-2562
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Country | US
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Telephone | 248-654-8492
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Fax | 248-710-2200
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Provider Business Mailing Address
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Address Line | 23800 ORCHARD LAKE RD STE 200
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-2562
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Country | US
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Telephone | 248-654-8492
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Fax | 248-710-2200
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 5101016547
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License Number State | MI
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