Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD455833 | PA |
N | 111NI0900X | Internist | MD455833 | PA |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 69467 | WI |
Y | 207RC0000X | Internist - Cardiovascular Disease | 69467 | WI |
NPI | 1245542166 |
---|---|
Provider Name | Farhan Raza |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2010 |
Last Update Date | 07/01/2021 |