Provider Demographics
NPI:1235106915
Name:RAZA, SYED MUHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:MUHAMMAD
Last Name:RAZA
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 1:18025 FORT ST
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-7432
Mailing Address - Country:US
Mailing Address - Phone:734-283-5555
Mailing Address - Fax:734-283-1600
Practice Address - Street 1:18025 FORT ST
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:MI
Practice Address - Zip Code:48193
Practice Address - Country:US
Practice Address - Phone:734-283-5555
Practice Address - Fax:734-283-1600
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301088026207RS0012X, 207RP1001X
AL4301088026207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1235106915Medicaid
MI1235106915Medicaid
MI0H27304OtherBLUE CROSS
MI1235106915Medicaid
PA082327HB1Medicare ID - Type Unspecified