Provider Demographics
NPI:1801878806
Name:DRAW, AZMI (MD)
Entity type:Individual
Prefix:
First Name:AZMI
Middle Name:
Last Name:DRAW
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 1:10214 WORTHINGTON LN
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-8551
Mailing Address - Country:US
Mailing Address - Phone:502-216-0191
Mailing Address - Fax:
Practice Address - Street 1:10214 WORTHINGTON LN
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-8551
Practice Address - Country:US
Practice Address - Phone:502-216-0191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26883207RP1001X
KY36883207RC0200X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64045545Medicaid
KYH53742Medicare UPIN
KY0366659Medicare ID - Type Unspecified