Provider Demographics
NPI:1013984269
Name:CHANGEZI, HAMEEM (MD)
Entity Type:Individual
Prefix:
First Name:HAMEEM
Middle Name:
Last Name:CHANGEZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:5084 VILLA LINDE PKWY
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3422
Mailing Address - Country:US
Mailing Address - Phone:810-600-3399
Mailing Address - Fax:810-600-3398
Practice Address - Street 1:5084 VILLA LINDE PKWY
Practice Address - Street 2:SUITE 6
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3422
Practice Address - Country:US
Practice Address - Phone:810-600-3399
Practice Address - Fax:810-600-3398
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301064119207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1042238OtherHEALTH PLUS
MI1013984269Medicaid
MI1013984269Medicaid
MI1703003Medicare PIN