Provider Demographics
NPI:1467010488
Name:IJAZ, KINZA (MD)
Entity Type:Individual
Prefix:MS
First Name:KINZA
Middle Name:
Last Name:IJAZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6071 OUTER DRIVE WEST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235
Mailing Address - Country:US
Mailing Address - Phone:313-966-3300
Mailing Address - Fax:313-916-8863
Practice Address - Street 1:6071 OUTER DRIVE WEST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-966-3300
Practice Address - Fax:313-916-8863
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program