1518541721 NPI number — MUHAMMAD ALI RAZA M.D.

Table of content: MUHAMMAD ALI RAZA M.D. (NPI 1518541721)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518541721 NPI number — MUHAMMAD ALI RAZA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAZA
Provider First Name:
MUHAMMAD
Provider Middle Name:
ALI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518541721
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/17/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1086 FRANKLIN STREET, GME OFFICE, CONEMAUGH MEMORIAL
Provider Second Line Business Mailing Address:
E3-349 NANCY MARANO
Provider Business Mailing Address City Name:
JOHNSTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-534-9845
Provider Business Mailing Address Fax Number:
814-534-5599

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1199 PRINCE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30606-2797
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-475-5076
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/12/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208M00000X , with the licence number:  99748 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: MT220118 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 99748 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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