Provider Demographics
NPI:1740474329
Name:SAMINA KAZMI MD PLLC
Entity type:Organization
Organization Name:SAMINA KAZMI MD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:G
Authorized Official - Last Name:KAZMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-344-0166
Mailing Address - Street 1:415 MORRIS ST STE 403
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1854
Mailing Address - Country:US
Mailing Address - Phone:304-344-0166
Mailing Address - Fax:304-344-5105
Practice Address - Street 1:415 MORRIS ST STE 403
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1854
Practice Address - Country:US
Practice Address - Phone:304-344-0166
Practice Address - Fax:304-344-5105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV208872084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2004431000Medicaid
WV2004431000Medicaid