Healthcare Provider Details

I. General information

NPI: 1295507382
Provider Name (Legal Business Name): SMR MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2084 S LIVERNOIS RD
ROCHESTER HILLS MI
48307-3749
US

IV. Provider business mailing address

2084 S LIVERNOIS RD
ROCHESTER HILLS MI
48307-3749
US

V. Phone/Fax

Practice location:
  • Phone: 248-659-2861
  • Fax: 833-467-1525
Mailing address:
  • Phone: 248-659-2861
  • Fax: 833-467-1525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SYED RAZA
Title or Position: OWNER
Credential: MD
Phone: 248-659-2861