Provider Demographics
NPI:1912576745
Name:RAZA, AHMED (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
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:CHRISTINE FARNHAM, UNIVERSITY OF VERMONT MEDICAL CENTER
Mailing Address - Street 2:111 COLCHESTER AVE
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401
Mailing Address - Country:US
Mailing Address - Phone:802-847-4707
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF VERMONT MEDICAL CENTER
Practice Address - Street 2:111 COLCHESTER AVE
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401
Practice Address - Country:US
Practice Address - Phone:802-847-4707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program