MEDICARE: SYED MOHAMMED HUSSAIN RAZA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	4301088297	MI
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	5315040199	MI
3	207RP1001X	Pulmonary Disease Physician	4301088297	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1346398971	OTHER	MI	GRP NPI
2	SR040199	OTHER	MI	LICENSE
3	20-5485614	OTHER	MI	TAX ID
4	110F336360	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1578737219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYED MOHAMMED HUSSAIN RAZA MD

Provider Business Mailing Address
First Line	:	2084 S LIVERNOIS RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-3749
Country	:	US
Telephone Number	:	248-659-2861
Fax Number	:	833-467-1525

Provider Business Practice Location Address
First Line	:	2084 S LIVERNOIS RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-3749
Country	:	US
Telephone Number	:	248-659-2861
Fax Number	:	833-467-1525

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2008
Last Update Date	:	10/23/2023

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