MEDICARE: DR. SAMERAH G RAZUMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	ME0082363	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184672164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMERAH G RAZUMAN M.D.

Provider Business Mailing Address
First Line	:	2000 HARTMAN ROAD
Second Line	:	SUITE 1
City	:	FORT PIERCE
State	:	FL
Zip	:	34950-4830
Country	:	US
Telephone Number	:	772-465-1170
Fax Number	:	772-465-1171

Provider Business Practice Location Address
First Line	:	2000 HARTMAN RD STE 1
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34947-4412
Country	:	US
Telephone Number	:	772-465-1170
Fax Number	:	772-465-1171

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	04/26/2022

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