Provider Demographics
NPI:1851366892
Name:AZIE, NNAMDI (MD)
Entity Type:Individual
Prefix:DR
First Name:NNAMDI
Middle Name:
Last Name:AZIE
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 1:951 COMMERCE PKWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-4040
Mailing Address - Country:US
Mailing Address - Phone:419-227-7702
Mailing Address - Fax:419-227-7991
Practice Address - Street 1:951 COMMERCE PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-4040
Practice Address - Country:US
Practice Address - Phone:419-227-7702
Practice Address - Fax:419-227-7991
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-090881208G00000X
DEC1-0010283208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2848431Medicaid
DEH77849Medicare UPIN
OH2848431Medicaid
OH016014550Medicare PIN