Provider Demographics
NPI:1023395498
Name:TAHIR, AZHAR MUNIR (MD)
Entity Type:Individual
Prefix:DR
First Name:AZHAR
Middle Name:MUNIR
Last Name:TAHIR
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:PO BOX 20043
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14602-0043
Mailing Address - Country:US
Mailing Address - Phone:607-765-8129
Mailing Address - Fax:
Practice Address - Street 1:2748 E HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-9354
Practice Address - Country:US
Practice Address - Phone:607-765-8129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-12
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190786207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine