Provider Demographics
NPI:1437367398
Name:AZAM, ANITA (MD)
Entity Type:Individual
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First Name:ANITA
Middle Name:
Last Name:AZAM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3601 A. STREET
Mailing Address - Street 2:ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN - ENDOCRINOLOGY
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134
Mailing Address - Country:US
Mailing Address - Phone:215-427-5000
Mailing Address - Fax:215-427-8105
Practice Address - Street 1:3601 A. STREET
Practice Address - Street 2:ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134
Practice Address - Country:US
Practice Address - Phone:215-427-8100
Practice Address - Fax:215-427-8105
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2020-02-03
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Provider Licenses
StateLicense IDTaxonomies
MT810952080P0205X
NC2007-012322080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology