Provider Demographics
NPI:1154505253
Name:AZIZ, HAMMAD AMJAD (MD)
Entity Type:Individual
Prefix:
First Name:HAMMAD
Middle Name:AMJAD
Last Name:AZIZ
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 1:300 STONECREST BLVD STE 410
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6802
Mailing Address - Country:US
Mailing Address - Phone:615-220-6144
Mailing Address - Fax:615-220-3663
Practice Address - Street 1:300 STONECREST BLVD STE 410
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6802
Practice Address - Country:US
Practice Address - Phone:615-220-6144
Practice Address - Fax:615-220-3663
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246230207R00000X
CT046003207R00000X
DEC1-0011801207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT110010652Medicare PIN