MEDICARE: DR. SHAZIA 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	207RN0300X	Nephrology Physician	4301091041	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	P00473883	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1033514	OTHER	MI	MCLAREN HEALTH ADVANTAGE
2	1103313911	OTHER	MI	BLUE CROSS BLUE SHIELD
3	200000016236	OTHER	MI	PHP
4	200000016236	OTHER	MI	PHP-FAMILYCARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	1033514	OTHER	MI	MCLAREN HEALTH PLAN-COMMERCIAL
9	1103313911	OTHER	MI	BLUE CARE NETWORK

General Provider Information

NPI Number	:	1831176189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAZIA RAZA MD

Provider Business Mailing Address
First Line	:	4020 VENOY RD STE 700
Second Line	:
City	:	WAYNE
State	:	MI
Zip	:	48184-1891
Country	:	US
Telephone Number	:	734-454-8001
Fax Number	:

Provider Business Practice Location Address
First Line	:	4020 VENOY RD STE 700
Second Line	:
City	:	WAYNE
State	:	MI
Zip	:	48184-1891
Country	:	US
Telephone Number	:	734-454-8001
Fax Number	:

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	06/23/2020

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Directions to “ DR. SHAZIA RAZA MD” Practice Location

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