Healthcare Provider Details

I. General information

NPI: 1306883376
Provider Name (Legal Business Name): MUHAMMAD RAIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 01/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 HIOAKS RD STE F
RICHMOND VA
23225-4038
US

IV. Provider business mailing address

PO BOX 13948
RICHMOND VA
23225-8919
US

V. Phone/Fax

Practice location:
  • Phone: 804-464-2271
  • Fax:
Mailing address:
  • Phone: 804-464-2271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101240720
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number23050
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101240720
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number0101240720
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number0101240720
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License Number0101240720
License Number StateVA
# 7
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number0101240720
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: