Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 0102205207 | VA |
N | 207Q00000X | Family Doctor | 0102205207 | VA |
NPI | 1013303486 |
---|---|
Provider Name | Mukarram Razvi |
First Address | Blacksburg, VA 24060-6601 |
Second Address | Blacksburg, VA 24060-6601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2015 |
Last Update Date | 10/02/2020 |