Provider Demographics
NPI:1871817189
Name:NAWAZ, HAMAYUN MOIN (MD)
Entity Type:Individual
Prefix:DR
First Name:HAMAYUN
Middle Name:MOIN
Last Name:NAWAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:85292 AMAGANSETT DR
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-8713
Mailing Address - Country:US
Mailing Address - Phone:310-990-1458
Mailing Address - Fax:310-861-5414
Practice Address - Street 1:2928 N BELT LINE RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5247
Practice Address - Country:US
Practice Address - Phone:214-307-7786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108784207R00000X
TXT9759207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine