Provider Demographics
NPI:1467533323
Name:NAEEM A QAZI MD PC
Entity Type:Organization
Organization Name:NAEEM A QAZI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAEEM
Authorized Official - Middle Name:A
Authorized Official - Last Name:QAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-326-1136
Mailing Address - Street 1:15 WESTWOOD MEDICAL PARK
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-2000
Mailing Address - Country:US
Mailing Address - Phone:276-326-1136
Mailing Address - Fax:276-326-1137
Practice Address - Street 1:15 WESTWOOD MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-2000
Practice Address - Country:US
Practice Address - Phone:276-326-1136
Practice Address - Fax:276-326-1137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040972174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810002520Medicaid
WV001709876OtherMOUNTAIN STATE BC BS
WV3810002518Medicaid
WV001709875OtherMOUNTAIN STATE BC BS
VAC06159Medicare ID - Type UnspecifiedTRAILBLAZER
WV9306913Medicare ID - Type UnspecifiedPALMETTO
WV3810002518Medicaid
WV3810002520Medicaid