Basic Information
| Provider Information | |||||||||
| NPI: | 1467537100 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAZAZ | ||||||||
| FirstName: | SAPNA | ||||||||
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| Credential: | M.B.B.S, MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 45 SYCAMORE AVE | ||||||||
| Address2: | APT # 1423 | ||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294076710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435138674 | ||||||||
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| Practice Location | |||||||||
| Address1: | 96 JONATHAN LUCAS ST | ||||||||
| Address2: | SUITE 418 | ||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294258900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437923072 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | LL25970 | SC | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.