Provider Demographics
NPI:1922203082
Name:AZMI, SYED S (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:S
Last Name:AZMI
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 1:965 RIDGE LAKE BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9401
Mailing Address - Country:US
Mailing Address - Phone:901-227-7015
Mailing Address - Fax:901-227-8591
Practice Address - Street 1:7900 AIRWAYS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-4113
Practice Address - Country:US
Practice Address - Phone:662-349-2442
Practice Address - Fax:662-349-8551
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE6676207RH0003X
MS21226207RH0003X
TN46560207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4320003OtherBCBS
MS21226OtherMS LICENSE
TN103I831043Medicare PIN
TN4320003OtherBCBS
TN103I831043Medicare PIN