MEDICARE: SAYYID S RAZA MD

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	207R00000X	Internal Medicine Physician	4301066874	MI

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	:	1336176486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAYYID S RAZA MD

Provider Business Mailing Address
First Line	:	1573 WEDGEWOOD PL
Second Line	:
City	:	ESSEXVILLE
State	:	MI
Zip	:	48732-3203
Country	:	US
Telephone Number	:	989-891-0955
Fax Number	:	989-891-0966

Provider Business Practice Location Address
First Line	:	2108 16TH ST
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-7608
Country	:	US
Telephone Number	:	989-891-0955
Fax Number	:	989-891-0966

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

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	01/22/2021

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