Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 4301095652 | MI |
Y | 207RR0500X | Rheumatology | 52391 | TN |
NPI | 1063636306 |
---|---|
Provider Name | Syed Hasan Raza |
First Address | Memphis, TN 38103-2807 |
Second Address | Memphis, TN 38103-3409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 06/03/2015 |