MEDICARE: DR. NIDA BUTOOL RIZVI 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
1	207R00000X	Internal Medicine Physician	MD446768	PA
2	207R00000X	Internal Medicine Physician	Q3586	TX
3	208M00000X	Hospitalist Physician	MD446768	PA

General Provider Information

NPI Number	:	1174757959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIDA BUTOOL RIZVI M.D.

Provider Business Mailing Address
First Line	:	3421 CONCORD RD
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-9001
Country	:	US
Telephone Number	:	717-851-4005
Fax Number	:	717-812-2495

Provider Business Practice Location Address
First Line	:	1001 S GEORGE ST FL 4
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17403-3676
Country	:	US
Telephone Number	:	717-851-4005
Fax Number	:	717-812-2495

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

Provider Enumeration Date	:	05/08/2009
Last Update Date	:	03/12/2026

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