Provider Demographics
NPI:1306883376
Name:RAIS, MUHAMMAD (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:
Last Name:RAIS
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:PO BOX 13948
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-8919
Mailing Address - Country:US
Mailing Address - Phone:804-464-2271
Mailing Address - Fax:
Practice Address - Street 1:909 HIOAKS RD STE F
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4038
Practice Address - Country:US
Practice Address - Phone:804-464-2271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2009-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240720207P00000X, 208000000X, 207KA0200X, 2080P0214X, 2080S0012X, 207RS0012X
SC23050208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC20-2660098OtherGAFFNEY MEDICAL ASSOCIATE
VA1306883376Medicaid
SCGP4210Medicaid
SCGP4210Medicaid
VAG45657Medicare UPIN
VA01470V21Medicare PIN
SC8291Medicare ID - Type UnspecifiedDR. MUHAMMAD RAIS