Provider Demographics
NPI:1568687606
Name:NAEEM A QAZI MD FACC PC
Entity Type:Organization
Organization Name:NAEEM A QAZI MD FACC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
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:304-325-8171
Mailing Address - Street 1:1331 SOUTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-4320
Mailing Address - Country:US
Mailing Address - Phone:304-325-8171
Mailing Address - Fax:304-325-3914
Practice Address - Street 1:1331 SOUTHVIEW DR
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-4320
Practice Address - Country:US
Practice Address - Phone:304-325-8171
Practice Address - Fax:304-325-3914
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAEEM A QAZI MD FACC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-16
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06159Medicaid
WV3810002520Medicaid
WV9306911Medicare PIN
WV3810002520Medicaid