Provider Demographics
NPI:1831332451
Name:NAQVI, HASAN FARAZ (MD)
Entity type:Individual
Prefix:DR
First Name:HASAN
Middle Name:FARAZ
Last Name:NAQVI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SAIYID HASAN
Other - Middle Name:FARAZ
Other - Last Name:NAQVI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1236 E ELIZABETH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4000
Mailing Address - Country:US
Mailing Address - Phone:970-488-1668
Mailing Address - Fax:
Practice Address - Street 1:1236 E ELIZABETH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4000
Practice Address - Country:US
Practice Address - Phone:970-488-1668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0048520207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO62384279Medicaid
CO62384279Medicaid