Provider Demographics
NPI:1942339874
Name:HAFEEZ, NAZIMA S (MD)
Entity Type:Individual
Prefix:DR
First Name:NAZIMA
Middle Name:S
Last Name:HAFEEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1195 PADDINGTON ROAD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187
Mailing Address - Country:US
Mailing Address - Phone:734-981-6506
Mailing Address - Fax:
Practice Address - Street 1:2200 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-7101
Practice Address - Country:US
Practice Address - Phone:419-251-1400
Practice Address - Fax:419-251-1797
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301073258207Q00000X
OH35.083468207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2836293Medicaid
OH4236413Medicare PIN