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General NPI Number Information
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NPI Number | 1619933074
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Entity Type | Individual
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Provider Name | RAZA ALI MD
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 234 E GRAY ST SUITE 858
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City | LOUISVILLE
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State | KY
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Zip | 40202-1900
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Country | US
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Telephone | 502-583-1799
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Fax | 502-583-1792
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Provider Business Mailing Address
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Address Line | 234 E GRAY ST STE 858
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City | LOUISVILLE
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State | KY
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Zip | 40202-1927
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Country | US
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Telephone | 502-583-1799
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Fax | 502-583-1792
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 42311
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 01066017A
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License Number State | IN
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