Provider Demographics
NPI:1013303486
Name:RAZVI, MUKARRAM (DO)
Entity Type:Individual
Prefix:
First Name:MUKARRAM
Middle Name:
Last Name:RAZVI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1999 S MAIN ST STE 405
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-6601
Mailing Address - Country:US
Mailing Address - Phone:540-930-0539
Mailing Address - Fax:540-317-3164
Practice Address - Street 1:1999 S MAIN ST STE 405
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6601
Practice Address - Country:US
Practice Address - Phone:540-930-0539
Practice Address - Fax:540-317-3164
Is Sole Proprietor?:No
Enumeration Date:2015-04-12
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102205207204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM