Individual
POUYAN RAZMINIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3134 N CLARK ST, CHICAGO, IL 60657-4414
(773) 880-9273
Mailing address
2001 KINGSLEY AVE, ORANGE PARK, FL 32073-5156
(904) 639-2015
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
125081674
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2020
Last updated
05/13/2023
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