Provider Demographics
NPI:1578531927
Name:HASHMI, AZRA (MD)
Entity Type:Individual
Prefix:
First Name:AZRA
Middle Name:
Last Name:HASHMI
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 1:6401 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2363
Mailing Address - Country:US
Mailing Address - Phone:313-846-8800
Mailing Address - Fax:313-846-0884
Practice Address - Street 1:6401 MILLER RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2363
Practice Address - Country:US
Practice Address - Phone:313-846-8800
Practice Address - Fax:313-846-0884
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301072566208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H67796Medicare UPIN