Provider Demographics
NPI:1194383497
Name:MUKARRAM RAZVI, DO, PLLC
Entity Type:Organization
Organization Name:MUKARRAM RAZVI, DO, PLLC
Other - Org Name:NEW RIVER OSTEOPATHY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MUKARRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZVI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:540-930-0539
Mailing Address - Street 1:1999 S MAIN ST STE 405
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-6601
Mailing Address - Country:US
Mailing Address - Phone:540-930-0539
Mailing Address - Fax:540-317-3164
Practice Address - Street 1:1999 S MAIN ST STE 405
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6601
Practice Address - Country:US
Practice Address - Phone:540-930-0539
Practice Address - Fax:540-317-3164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-31
Last Update Date:2023-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service