Basic Information
| Provider Information | |||||||||
| NPI: | 1407989601 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIZK | ||||||||
| FirstName: | SALIM | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 FAIRMOUNT AVE STE 103 | ||||||||
| Address2: | |||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212865457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104947921 | ||||||||
| FaxNumber: | 4109028247 | ||||||||
| Practice Location | |||||||||
| Address1: | 515 FAIRMOUNT AVE STE 500 | ||||||||
| Address2: | |||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212865466 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104941662 | ||||||||
| FaxNumber: | 4104941718 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | D0041637 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0200X | D0041637 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1402211 | 01 | UNITED | OTHER | E5540016 | 01 | BLUE CHOICE | OTHER | 53644803 | 01 | BC BS MARYLAND | OTHER | 290010179 | 01 | RR MEDICARE | OTHER |