Provider Demographics
NPI:1477709301
Name:MIR, RAAFIA (MD)
Entity Type:Individual
Prefix:
First Name:RAAFIA
Middle Name:
Last Name:MIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 OAKLAND AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-2019
Mailing Address - Country:US
Mailing Address - Phone:248-977-3062
Mailing Address - Fax:248-977-3081
Practice Address - Street 1:31 OAKLAND AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-2019
Practice Address - Country:US
Practice Address - Phone:248-977-3062
Practice Address - Fax:248-977-3081
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301095750207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine