Provider Demographics
NPI:1548615784
Name:GASMELSEED, AZZA (MD)
Entity Type:Individual
Prefix:
First Name:AZZA
Middle Name:
Last Name:GASMELSEED
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 1:341 GREAT CIRCLE RD APT 166
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-3055
Mailing Address - Country:US
Mailing Address - Phone:615-478-9323
Mailing Address - Fax:913-588-8387
Practice Address - Street 1:341 GREAT CIRCLE RD APT 166
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-3055
Practice Address - Country:US
Practice Address - Phone:615-478-9323
Practice Address - Fax:913-588-8387
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker