| Miraja Md Pa Inc | |
|
4612 Brookemere Dr Glen Allen VA 23060-6504 | |
| (804) 441-9000 | |
| (804) 522-1533 |
| Full Name | Miraja Md Pa Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4612 Brookemere Dr, Glen Allen, Virginia |
| Authorized Official Name and Position | Muhammad Ishtiaq Raja (OWNER) |
| Authorized Official Contact | 8044419000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miraja Md Pa Inc 4612 Brookemere Dr Glen Allen VA 23060-6504 Ph: (804) 503-6650 | Miraja Md Pa Inc 4612 Brookemere Dr Glen Allen VA 23060-6504 Ph: (804) 441-9000 |
| NPI Number | 1891549028 |
|---|---|
| Provider Enumeration Date | 04/15/2024 |
| Last Update Date | 08/30/2024 |
| Medicare PECOS PAC ID | 3971944893 |
|---|---|
| Medicare Enrollment ID | O20240509002253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891549028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Muhammad Ishtiaq Raja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932190451 PECOS PAC ID: 6608899323 Enrollment ID: I20060109000950 |
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