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Organization

UNIVERSITY HEMATOLOGY ONCOLOGY GROUP INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAZA M SYED MBA (PRACTICE ADMINISTRATOR)
(314) 290-7501
Entity
Organization

Contact information

Practice address
1052 MARTIN LUTHER KING DR, SUITE 2, CENTRALIA, IL 62801-3002
(314) 290-7501
(314) 290-7575
Mailing address
4921 PARKVIEW PL, SUITE 14C, SAINT LOUIS, MO 63110-1032
(314) 290-7501
(314) 290-7575

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
36-043159
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8221935
BCBS IL
IL
Enumeration date
09/24/2007
Last updated
02/19/2008
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