Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD431052 | PA |
N | 111NI0900X | Internist | MD431052 | PA |
N | 207R00000X | Internist | MD60454758 | WA |
N | 111NI0900X | Internist | MD60454758 | WA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD60454758 | WA |
NPI | 1073794160 |
---|---|
Provider Name | Dr. Eathar A Razak |
First Address | Tacoma, WA 98405-4499 |
Second Address | Tacoma, WA 98405-4499 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2007 |
Last Update Date | 11/08/2014 |