Individual
NASSER RAZACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-5111
(313) 745-3500
Mailing address
PO BOX 100374, GAINESVILLE, FL 32610-0374
(352) 265-0291
(352) 265-0279
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301081063
MI
2085R0202X
Diagnostic Radiology Physician
ME92656
FL
2085R0204X
Vascular & Interventional Radiology Physician
2023020198
MO
2085R0204X
Vascular & Interventional Radiology Physician
ME92656
FL
2085U0001X
Diagnostic Ultrasound Physician
ME92656
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105114500
—
FL
05
—
200125691
—
MO
05
—
273135500
—
FL
01
—
4301081063
MI LICENSE
MI
Enumeration date
08/16/2006
Last updated
04/13/2026
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