Provider Demographics
NPI:1386913465
Name:RAZAVI, NASEEM B (MD)
Entity type:Individual
Prefix:DR
First Name:NASEEM
Middle Name:B
Last Name:RAZAVI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4107 WHISPER CREEK DRIVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:36 RUSS ST FL 3
Practice Address - Street 2:STE 738
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-1520
Practice Address - Country:US
Practice Address - Phone:860-310-9549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2024-04-29
Deactivation Date:2013-10-24
Deactivation Code:
Reactivation Date:2016-10-05
Provider Licenses
StateLicense IDTaxonomies
CT76796208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty