Provider Demographics
NPI:1396515219
Name:AKHTER, KAZI
Entity type:Individual
Prefix:
First Name:KAZI
Middle Name:
Last Name:AKHTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NORTON IM RESIDENCY CLINIC
Mailing Address - Street 2:96 15TH ST. NW, SUITE 111
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273
Mailing Address - Country:US
Mailing Address - Phone:276-439-1872
Mailing Address - Fax:276-439-1872
Practice Address - Street 1:NORTON IM RESIDENCY CLINIC
Practice Address - Street 2:96 15TH ST. SUITE 111
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273
Practice Address - Country:US
Practice Address - Phone:276-439-1872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty