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General NPI Number Information
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NPI Number | 1285727461
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Entity Type | Individual
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Provider Name | SAADIA TAUFIQ RAZA MD
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 11/12/2021
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Provider Practice Location Address
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Address Line | 6704 KEATON CORP PKWY
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City | O FALLON
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State | MO
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Zip | 63368-8680
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Country | US
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Telephone | 636-300-9596
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Fax | 636-300-9598
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Provider Business Mailing Address
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Address Line | 6704 KEATON CORP PKWY
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City | O FALLON
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State | MO
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Zip | 63368-8680
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Country | US
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Telephone | 636-300-9596
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Fax | 636-300-9598
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2003010750
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 2003010750
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License Number State | MO
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