Provider Demographics
NPI:1811001720
Name:RAZA, TASLEEM
Entity Type:Individual
Prefix:
First Name:TASLEEM
Middle Name:
Last Name:RAZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPTT OF MEDICINE (PULMONARY), HAMAD GENERAL HOSPITAL
Mailing Address - Street 2:P.O.BOX: 3050
Mailing Address - City:DOHA
Mailing Address - State:DOHA
Mailing Address - Zip Code:3050
Mailing Address - Country:QA
Mailing Address - Phone:974-597-5059
Mailing Address - Fax:
Practice Address - Street 1:CLEMENT J ZABLOCKI VETERANS AFFAIRS MEDICAL CTR
Practice Address - Street 2:5000 W. NATIONAL AVENUE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53295-0001
Practice Address - Country:US
Practice Address - Phone:414-384-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37159-020207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI06522Medicare UPIN