Provider Demographics
NPI:1518963198
Name:KAZI, NADEEM A (MD)
Entity Type:Individual
Prefix:DR
First Name:NADEEM
Middle Name:A
Last Name:KAZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1780 E FLORENCE BLVD
Mailing Address - Street 2:STE 104
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-4782
Mailing Address - Country:US
Mailing Address - Phone:520-426-1928
Mailing Address - Fax:520-426-9088
Practice Address - Street 1:1780 E FLORENCE BLVD
Practice Address - Street 2:STE 104
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-4782
Practice Address - Country:US
Practice Address - Phone:520-426-1928
Practice Address - Fax:520-426-9088
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ25728207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z0212OtherHEALTHNET
95999OtherPACIFICARE PPO
AZAZ0810620OtherBCBS
PIM21KAZINA1OtherMERCYCAREPLAN PREMIUM SHA
601101OtherHUMANA
AZ393968Medicaid
628670OtherANTHEM BLUE CROSS
95964OtherPACIFICARE HMO
100011792OtherRAILROAD MEDICARE
7612839OtherDIVISION OF MEDICAL ASST
1002828OtherAETNA
AZ1Z0212OtherHEALTHNET
PIM21KAZINA1OtherMERCYCAREPLAN PREMIUM SHA