Provider Demographics
NPI:1679523898
Name:PARWAIZ, RIFAT (MD)
Entity type:Individual
Prefix:DR
First Name:RIFAT
Middle Name:
Last Name:PARWAIZ
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:PO BOX 863
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36361-0863
Mailing Address - Country:US
Mailing Address - Phone:334-443-1211
Mailing Address - Fax:334-443-0131
Practice Address - Street 1:1519 ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-3719
Practice Address - Country:US
Practice Address - Phone:334-774-7610
Practice Address - Fax:334-774-7288
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17023208000000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009941546Medicaid
AL51539105OtherBLUE CROSS BLUE SHIELD OF
ALC844Medicare PIN
AL009941546Medicaid
AL051558623Medicare PIN