Provider Demographics
NPI:1982709382
Name:SAMI, RAZIA (MD)
Entity Type:Individual
Prefix:DR
First Name:RAZIA
Middle Name:
Last Name:SAMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3725 VIOLA LANE
Mailing Address - Street 2:
Mailing Address - City:MURPHYSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62966
Mailing Address - Country:US
Mailing Address - Phone:618-932-3166
Mailing Address - Fax:618-457-1999
Practice Address - Street 1:309 W SAINT LOUIS ST
Practice Address - Street 2:
Practice Address - City:WEST FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:62896-2099
Practice Address - Country:US
Practice Address - Phone:618-932-3166
Practice Address - Fax:618-457-1999
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036083535207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL359140Medicare PIN