Provider Demographics
NPI:1891766549
Name:AZMI, MALALAI (MD)
Entity Type:Individual
Prefix:
First Name:MALALAI
Middle Name:
Last Name:AZMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:12454 HARTLEY ST
Mailing Address - Street 2:PO BOX 188
Mailing Address - City:STONY CREEK
Mailing Address - State:VA
Mailing Address - Zip Code:23882-3302
Mailing Address - Country:US
Mailing Address - Phone:434-246-6100
Mailing Address - Fax:434-246-6614
Practice Address - Street 1:12454 HARTLEY ST
Practice Address - Street 2:
Practice Address - City:STONY CREEK
Practice Address - State:VA
Practice Address - Zip Code:23882-3302
Practice Address - Country:US
Practice Address - Phone:434-246-6100
Practice Address - Fax:434-246-6614
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101235956207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007389S80Medicare PIN
I30788Medicare UPIN