Provider Demographics
NPI:1447214994
Name:RAZA, NAEEM (MD)
Entity Type:Individual
Prefix:DR
First Name:NAEEM
Middle Name:
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 1:1100 REID PKWY
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1157
Mailing Address - Country:US
Mailing Address - Phone:765-935-8923
Mailing Address - Fax:765-935-8407
Practice Address - Street 1:1050 REID PKWY STE 110
Practice Address - Street 2:REID HEALTH GASTROENTEROLOGY AND RHEUMATOLOGY
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1156
Practice Address - Country:US
Practice Address - Phone:765-935-8923
Practice Address - Fax:765-935-8407
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417881174400000X, 207R00000X
IN01070885A207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201066770Medicaid
PA001969948Medicaid
INM400071066Medicare PIN
PA001969948Medicaid
074061Medicare PIN
IN465610003Medicare PIN
PAH95847Medicare UPIN