Provider Demographics
NPI:1871521898
Name:RIZZO, ANNE G (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:G
Last Name:RIZZO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 GALLOWS RD
Mailing Address - Street 2:PHYSICIAN BILLING
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3307
Mailing Address - Country:US
Mailing Address - Phone:703-776-2545
Mailing Address - Fax:703-776-2917
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:PHYSICIAN BILLING
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3307
Practice Address - Country:US
Practice Address - Phone:703-776-2545
Practice Address - Fax:703-776-2917
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237369208600000X
TXP55632086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G30181Medicare UPIN
DC015739I83Medicare PIN