Provider Demographics
NPI:1699744185
Name:JAFFER, ALIRAZA (MD)
Entity type:Individual
Prefix:DR
First Name:ALIRAZA
Middle Name:
Last Name:JAFFER
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 1:5070 BROOKDALE RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-3610
Mailing Address - Country:US
Mailing Address - Phone:248-749-6630
Mailing Address - Fax:
Practice Address - Street 1:1560 E MAPLE RD STE 290
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1135
Practice Address - Country:US
Practice Address - Phone:248-749-6630
Practice Address - Fax:888-248-6777
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065963207LP2900X, 208VP0000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G93351Medicare UPIN
OF36192063Medicare PIN