Provider Demographics
NPI:1578737219
Name:RAZA, SYED MOHAMMED HUSSAIN (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:MOHAMMED HUSSAIN
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 1:2084 S LIVERNOIS RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-3749
Mailing Address - Country:US
Mailing Address - Phone:248-659-2861
Mailing Address - Fax:833-467-1525
Practice Address - Street 1:2084 S LIVERNOIS RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-3749
Practice Address - Country:US
Practice Address - Phone:248-659-2861
Practice Address - Fax:833-467-1525
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301088297207R00000X, 207RP1001X
MI5315040199207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1346398971OtherGRP NPI
MISR040199OtherLICENSE
MI20-5485614OtherTAX ID
MI110F336360OtherBCBSM
MI0P41360Medicare PIN