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BASIMA MUHAMMED ABDUL-RAZAK MD

>> Pediatrics >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1346279460

Individual Registrant:
 BASIMA MUHAMMED ABDUL-RAZAK MD
Gender: F
Sole Proprietor

Location and contact information for practice:
601 E ROLLINS ST  ORLANDO, FL 32803 US
Tel: 407-975-0412  Fax: 407-975-0413

Contact information for business:
601 E ROLLINS ST  ORLANDO, FL 32803-1248 US
Tel: 407-975-0412  Fax: 407-975-0413

Registration Information:
NPI: 1346279460
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N208000000XAllopathic & Osteopathic Physicians
Pediatrics
CAC53991
N208000000XAllopathic & Osteopathic Physicians
Pediatrics
MI4301068389
N208M00000XAllopathic & Osteopathic Physicians
Hospitalist
FLME134057
Y208000000XAllopathic & Osteopathic Physicians
Pediatrics
FLME134057

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
GREAT LAKES HEALTH PLAN#14641201
MCARE PIN #1652801
4673447-10MI05
4331048-10MI05
CAPE PIN NUMBER00000005503A01
MIDWEST PIN #02386201
AETNA PROVIDER NUMBER768610201
BCBS/BCN PIN NUMBER063448401
HEALTH PLAN OF MICHIGAN#1650201




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