Provider Demographics
NPI:1033478136
Name:RAZ, AEYAL (MD,PHD)
Entity type:Individual
Prefix:DR
First Name:AEYAL
Middle Name:
Last Name:RAZ
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 EAGLE HTS
Mailing Address - Street 2:APT. K
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-1762
Mailing Address - Country:US
Mailing Address - Phone:608-515-0530
Mailing Address - Fax:
Practice Address - Street 1:1300 UNIVERSITY AVE
Practice Address - Street 2:ROOM 4605
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53706-1510
Practice Address - Country:US
Practice Address - Phone:608-263-6662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17763-875207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology