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Individual

DR. FAZAL I RAZIQ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1821 S WEBSTER AVE, GREEN BAY, WI 54301-2253
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301115856
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
4301504715
MI
207RP1001X
Pulmonary Disease Physician
4301504715
MI
207RP1001X
Pulmonary Disease Physician
Primary
82694-20
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100276589
WI
Enumeration date
07/05/2018
Last updated
12/18/2024
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