Provider Demographics
NPI:1689899791
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:304-487-2191
Mailing Address - Street 1:PO BOX 1069
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-4069
Mailing Address - Country:US
Mailing Address - Phone:304-487-2191
Mailing Address - Fax:304-425-2183
Practice Address - Street 1:120 12TH STREET EXT
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2352
Practice Address - Country:US
Practice Address - Phone:304-487-2191
Practice Address - Fax:304-425-2183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810002520Medicaid
WVCH8815Medicare ID - Type Unspecified
WV9306911Medicare ID - Type Unspecified