1871828699 NPI number — NOOR AHMED KAZI MD

Table of content: (NPI 1154348282)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871828699 NPI number — NOOR AHMED KAZI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAZI
Provider First Name:
NOOR
Provider Middle Name:
AHMED
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871828699
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3375 US ROUTE 60 E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25705-2837
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-525-7851
Provider Business Mailing Address Fax Number:
304-697-1286

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3389 WINFIELD RD
Provider Second Line Business Practice Location Address:
SUITE 8
Provider Business Practice Location Address City Name:
WINFIELD
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25213-9370
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-525-7851
Provider Business Practice Location Address Fax Number:
304-697-1286
Provider Enumeration Date:
10/13/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  23676 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084P0800X , with the licence number: 11321 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0005355002 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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