Basic Information
Provider Information
NPI: 1073764445
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAZA
FirstName: UMARA
MiddleName: ALI
NamePrefix: MS.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 636256
Address2: CENTRAL CREDENTIALING
City: CINCINNATI
State: OH
PostalCode: 452636256
CountryCode: US
TelephoneNumber: 5132453104
FaxNumber: 5135855511
Practice Location
Address1: 222 PIEDMONT AVE
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452194231
CountryCode: US
TelephoneNumber: 5134758521
FaxNumber: 5134757480
Other Information
ProviderEnumerationDate: 10/03/2008
LastUpdateDate: 07/06/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X35121860OHY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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