Provider Demographics
NPI:1285624544
Name:RAZAVI, SEID ALI (MD)
Entity type:Individual
Prefix:DR
First Name:SEID
Middle Name:ALI
Last Name:RAZAVI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3219 CLIFTON AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-3027
Mailing Address - Country:US
Mailing Address - Phone:513-861-1260
Mailing Address - Fax:513-872-7149
Practice Address - Street 1:3219 CLIFTON AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-3027
Practice Address - Country:US
Practice Address - Phone:513-861-1260
Practice Address - Fax:513-872-7149
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-042949207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0521886Medicaid
OH0521886Medicaid
OHRA0474263Medicare PIN
OHRA0474266Medicare PIN
OHRA0474261Medicare PIN
OHRA0474265Medicare PIN
OHH030510Medicare PIN