Basic Information
| Provider Information | |||||||||
| NPI: | 1346240587 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AZEEM | ||||||||
| FirstName: | IRFAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1824 WALTON WAY | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309043804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067379250 | ||||||||
| FaxNumber: | 7067330697 | ||||||||
| Practice Location | |||||||||
| Address1: | 1350 WALTON WAY | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309012612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067379250 | ||||||||
| FaxNumber: | 7067330697 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2005 | ||||||||
| LastUpdateDate: | 03/03/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 050978 | GA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.