Provider Demographics
NPI:1841432002
Name:RAZA, HYDER SYED (MD)
Entity Type:Individual
Prefix:
First Name:HYDER
Middle Name:SYED
Last Name:RAZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HYDER
Other - Middle Name:SYED
Other - Last Name:RAZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:22819 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2007
Mailing Address - Country:US
Mailing Address - Phone:313-769-5820
Mailing Address - Fax:313-769-5815
Practice Address - Street 1:22819 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2007
Practice Address - Country:US
Practice Address - Phone:313-769-5820
Practice Address - Fax:313-769-5815
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017569E208600000X
MI4301104718207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery