Provider Demographics
NPI:1730683038
Name:ISHTIAQ, RIZWAN (MD)
Entity type:Individual
Prefix:
First Name:RIZWAN
Middle Name:
Last Name:ISHTIAQ
Suffix:
Gender:M
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:MERCY ST. VINCENT MEDICAL CENTER
Mailing Address - Street 2:2213 CHERRY STREET
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608
Mailing Address - Country:US
Mailing Address - Phone:419-251-4554
Mailing Address - Fax:419-251-6795
Practice Address - Street 1:MERCY FAMILY CARE CENTER
Practice Address - Street 2:2213 FRANKLIN AVE
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43620
Practice Address - Country:US
Practice Address - Phone:419-251-2360
Practice Address - Fax:419-251-2393
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT67555208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist