MEDICARE: DR. RAJA ASSAD HANIF 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	207Q00000X	Family Medicine Physician	35.097776	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	603271	OTHER	OH	BUCKEYE COMMUNITY HEALTH
2	021367	OTHER	OH	PARAMOUNT HEALTH
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659513695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAJA ASSAD HANIF M.D.

Provider Business Mailing Address
First Line	:	4235 SECOR RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623
Country	:	US
Telephone Number	:	419-473-3561
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 EASTGATE RD
Second Line	:	STE I
City	:	TOLEDO
State	:	OH
Zip	:	43614-3024
Country	:	US
Telephone Number	:	419-385-5709
Fax Number	:

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

Provider Enumeration Date	:	04/06/2009
Last Update Date	:	05/10/2017

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