Healthcare Provider Details

I. General information

NPI: 1780675447
Provider Name (Legal Business Name): HASHIM RAZA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 LINCOLN WAY SUITE B
WHITE OAK PA
15131-1603
US

IV. Provider business mailing address

1303 LINCOLN WAY SUITE B
WHITE OAK PA
15131-1603
US

V. Phone/Fax

Practice location:
  • Phone: 412-673-7745
  • Fax: 412-673-7746
Mailing address:
  • Phone: 412-673-7745
  • Fax: 412-673-7746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD049441L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD049441L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: