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Individual

RAZIUDDIN AHMED

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
10570 BLUE STAR M HWY, SOUTH HAVEN, MI 49090-8923
(269) 978-3385
(269) 978-2711
Mailing address
10570 BLUE STAR M HWY, SOUTH HAVEN, MI 49090-8923
(269) 978-3385
(269) 978-2711

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E 4483
CA
213E00000X
Podiatrist
RA002029
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4952336
MI
01
5802579
BCBSM
MI
01
P00348699
RAILROAD MEDICARE
MI
Enumeration date
05/31/2005
Last updated
05/29/2009
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