Provider Demographics
NPI:1184649972
Name:SAQIB RAZAQ, M.D.,P.C.
Entity Type:Organization
Organization Name:SAQIB RAZAQ, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SAQIB
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZAQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-457-3100
Mailing Address - Street 1:1492 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-4210
Mailing Address - Country:US
Mailing Address - Phone:734-457-3100
Mailing Address - Fax:734-457-3200
Practice Address - Street 1:1492 N MONROE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-4210
Practice Address - Country:US
Practice Address - Phone:734-457-3100
Practice Address - Fax:734-457-3200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISR075015207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4363014Medicaid
MIH05943Medicare UPIN
MI4363014Medicaid