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General NPI Number Information
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NPI Number | 1225141328
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Entity Type | Individual
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Provider Name | NASSER RAZACK M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 3990 JOHN R ST
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City | DETROIT
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State | MI
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Zip | 48201-2018
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Country | US
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Telephone | 313-745-5111
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Fax | 313-745-3500
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Provider Business Mailing Address
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Address Line | 68 GLOBAL DR SUITE 100
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City | GREENVILLE
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State | SC
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Zip | 29607-4628
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Country | US
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Telephone | 864-644-2700
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Fax | 864-644-2709
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME92656
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 2023020198
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | ME92656
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | ME92656
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301081063
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License Number State | MI
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