Provider Demographics
NPI:1396762928
Name:NAQVI, SYED A (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:A
Last Name:NAQVI
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 1:11115 PLUM RIDGE PL # 6053
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-9398
Mailing Address - Country:US
Mailing Address - Phone:614-940-9431
Mailing Address - Fax:317-647-4283
Practice Address - Street 1:7420 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4559
Practice Address - Country:US
Practice Address - Phone:614-467-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036112262207P00000X
OH35080597207P00000X, 207R00000X
TXL7070207P00000X
NY219153207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0361122623Medicaid
OH2833698Medicaid
IL036112262Medicaid
IL0361122623Medicaid
OH4236742Medicare PIN
ILK22589Medicare PIN
IL638516Medicare UPIN
ILK13326Medicare PIN
IL036112262Medicaid