Provider Demographics
NPI:1184672164
Name:RAZUMAN, SAMERAH G (MD)
Entity type:Individual
Prefix:DR
First Name:SAMERAH
Middle Name:G
Last Name:RAZUMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2000 HARTMAN ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4830
Mailing Address - Country:US
Mailing Address - Phone:772-465-1170
Mailing Address - Fax:772-465-1171
Practice Address - Street 1:2000 HARTMAN RD STE 1
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34947-4412
Practice Address - Country:US
Practice Address - Phone:772-465-1170
Practice Address - Fax:772-465-1171
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0082363207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107239500Medicaid
FLH44644Medicare UPIN
FL261799400Medicaid