Provider Demographics
NPI:1629034079
Name:KAZI, RAHIL (MD)
Entity Type:Individual
Prefix:
First Name:RAHIL
Middle Name:
Last Name:KAZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 WATSON BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-3606
Mailing Address - Country:US
Mailing Address - Phone:478-929-8030
Mailing Address - Fax:478-929-8095
Practice Address - Street 1:1707 WATSON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3606
Practice Address - Country:US
Practice Address - Phone:478-929-8030
Practice Address - Fax:478-929-8095
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA041593207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000765278FMedicaid
GA000765278FMedicaid
F84065Medicare UPIN