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Individual

KHALID RAZZAQ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1424 STADIUM DRIVE, BLUEFIELD, WV 24701
(304) 327-5710
(304) 327-5781
Mailing address
1424 STADIUM DRIVE, BLUEFIELD, WV 24701
(304) 327-5710
(304) 327-5781

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
0101052490
VA
2084N0400X
Neurology Physician
Primary
18195
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001721810
BLUE CROSS BLUE SHIELD
05
007101562
VA
05
0090304000
WV
01
130019067
RR MEDICARE
Enumeration date
08/30/2006
Last updated
07/28/2010
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