Provider Demographics
NPI:1417972308
Name:RAZAQ, SAQIB (MD)
Entity Type:Individual
Prefix:DR
First Name:SAQIB
Middle Name:
Last Name:RAZAQ
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 1:1492 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:734-819-8026
Mailing Address - Fax:
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:734-819-8026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISR075015207R00000X
MI4301075015207R00000X
OH35.120561207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4363014Medicaid
MIH05943Medicare UPIN
MI0P18740Medicare PIN