Provider Demographics
NPI:1205574605
Name:RAZZAQ, ABDUL REHMAN (MD)
Entity type:Individual
Prefix:MR
First Name:ABDUL
Middle Name:REHMAN
Last Name:RAZZAQ
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 1:22250 PROVIDENCE DRIVE, SUITE #557
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4818
Mailing Address - Country:US
Mailing Address - Phone:248-849-3447
Mailing Address - Fax:248-849-8021
Practice Address - Street 1:22250 PROVIDENCE DRIVE, SUITE #557
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4818
Practice Address - Country:US
Practice Address - Phone:248-849-3447
Practice Address - Fax:248-849-8021
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program