Provider Demographics
NPI:1467408492
Name:AZMEH, WAREF (MD)
Entity Type:Individual
Prefix:DR
First Name:WAREF
Middle Name:
Last Name:AZMEH
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 1:4890 BLUEBONNET BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-9644
Mailing Address - Country:US
Mailing Address - Phone:252-769-3922
Mailing Address - Fax:225-769-3933
Practice Address - Street 1:4890 BLUEBONNET BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-9644
Practice Address - Country:US
Practice Address - Phone:225-769-3922
Practice Address - Fax:225-769-3933
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL-12821R207R00000X
LAMD12821R207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1548260Medicaid
IA1548260Medicaid
BA5009522OtherDEA
5E239Medicare ID - Type Unspecified