Provider Demographics
NPI:1851393151
Name:NIAZI, ASHER F (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHER
Middle Name:F
Last Name:NIAZI
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 1:145 N MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-7031
Mailing Address - Country:US
Mailing Address - Phone:770-592-3000
Mailing Address - Fax:
Practice Address - Street 1:145 N MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-7031
Practice Address - Country:US
Practice Address - Phone:770-592-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI44843207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34321600Medicaid
H79056Medicare UPIN
WI0787Medicare PIN