Basic Information
Provider Information
NPI: 1699932574
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AHMAD
FirstName: SUMERA
MiddleName: RAZI
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 1ST ST SW
Address2:  
City: ROCHESTER
State: MN
PostalCode: 559050001
CountryCode: US
TelephoneNumber: 5072842511
FaxNumber:  
Practice Location
Address1: 200 1ST ST SW
Address2:  
City: ROCHESTER
State: MN
PostalCode: 559050002
CountryCode: US
TelephoneNumber: 5072842511
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/19/2008
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X231700MAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RP1001X242274MAN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RP1001X62998MNY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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