Provider Demographics
NPI:1811068323
Name:RAZA, ASAD (MD)
Entity type:Individual
Prefix:DR
First Name:ASAD
Middle Name:
Last Name:RAZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19189 W 10 MILE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2453
Mailing Address - Country:US
Mailing Address - Phone:248-948-7485
Mailing Address - Fax:248-948-9031
Practice Address - Street 1:19189 W 10 MILE RD STE 200
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2453
Practice Address - Country:US
Practice Address - Phone:248-948-7485
Practice Address - Fax:248-948-9031
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI49941-020207Q00000X
MI4301097497207Q00000X, 207QG0300X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine