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General NPI Number Information
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NPI Number | 1194383497
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Entity Type | Organization
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Legal Business Name | MUKARRAM RAZVI, DO, PLLC
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Dates
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Enumeration Date | 05/31/2019
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Last Update Date | 03/05/2023
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Provider Practice Location Address
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Address Line | 1999 S MAIN ST STE 405
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City | BLACKSBURG
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State | VA
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Zip | 24060-6601
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Country | US
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Telephone | 540-930-0539
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Fax | 540-317-3164
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Provider Business Mailing Address
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Address Line | 1999 S MAIN ST STE 405
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City | BLACKSBURG
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State | VA
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Zip | 24060-6601
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Country | US
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Telephone | 540-930-0539
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Fax | 540-317-3164
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | MUKARRAM RAZVI
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Credential | DO
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Telephone | 540-930-0539
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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