Provider Demographics
NPI:1144103540
Name:RAZZAQ, TAHIR
Entity type:Individual
Prefix:
First Name:TAHIR
Middle Name:
Last Name:RAZZAQ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 AYELSBURY CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-7806
Mailing Address - Country:US
Mailing Address - Phone:773-600-8375
Mailing Address - Fax:
Practice Address - Street 1:447 AYELSBURY CT
Practice Address - Street 2:
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-7806
Practice Address - Country:US
Practice Address - Phone:773-600-8375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH035686183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist