Provider Demographics
NPI:1639585094
Name:NAWAZ, TALHA (MD)
Entity type:Individual
Prefix:
First Name:TALHA
Middle Name:
Last Name:NAWAZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10506B MONTGOMERY RD STE 501
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4402
Mailing Address - Country:US
Mailing Address - Phone:513-793-2654
Mailing Address - Fax:513-793-2962
Practice Address - Street 1:10506B MONTGOMERY RD STE 501
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4402
Practice Address - Country:US
Practice Address - Phone:513-793-2654
Practice Address - Fax:513-793-2962
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS27098207RP1001X
OH35.152279207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09008301Medicaid