Healthcare Provider Details

I. General information

NPI: 1083160253
Provider Name (Legal Business Name): MUHAMMAD KASHIF RAZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WYOMING ST STE SE3100B
DAYTON OH
45409-2722
US

IV. Provider business mailing address

3170 KETTERING BLVD BLDG B2ND
MORAINE OH
45439-1924
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-8394
  • Fax: 937-641-2780
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT211563
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.178386
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: