Provider Demographics
NPI:1265662258
Name:RANA, AZHAR NIAZ (MD,)
Entity type:Individual
Prefix:
First Name:AZHAR
Middle Name:NIAZ
Last Name:RANA
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 1:201 INTERSTATE DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24426-6441
Mailing Address - Country:US
Mailing Address - Phone:276-963-3554
Mailing Address - Fax:276-963-4653
Practice Address - Street 1:201 INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-6441
Practice Address - Country:US
Practice Address - Phone:681-207-2485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245110207W00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology