Provider Demographics
NPI:1093899494
Name:AZIZ, SAQIB (MD)
Entity Type:Individual
Prefix:
First Name:SAQIB
Middle Name:
Last Name:AZIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:60 COMMERCE DRIVE
Mailing Address - Street 2:P O BOX 1659
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-1659
Mailing Address - Country:US
Mailing Address - Phone:910-521-2900
Mailing Address - Fax:910-272-1654
Practice Address - Street 1:1212 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:NC
Practice Address - Zip Code:28340-1848
Practice Address - Country:US
Practice Address - Phone:910-628-6711
Practice Address - Fax:910-628-5735
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC133393207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905397Medicaid
NC14317OtherBCBS OF NC
NC2062501BMedicare ID - Type UnspecifiedS ROBESON MEDICAL CENTER
NC14317OtherBCBS OF NC
NC2062501AMedicare ID - Type UnspecifiedMAXTON MEDICAL CENTER
NC5905397Medicaid
NCI70877Medicare UPIN