Individual
MR. HASAN RAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
17 S RIVER ST, SUITE 254, JANESVILLE, WI 53548-3860
(608) 755-5260
Mailing address
17 S RIVER ST, SUITE 254, JANESVILLE, WI 53548-3860
(608) 755-5260
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
346123
WI
363AS0400X
Surgical Physician Assistant
346123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710382601
—
WI
Enumeration date
11/04/2014
Last updated
10/27/2015
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