Provider Demographics
NPI:1083848535
Name:VASI, AZEEM Z (DO)
Entity type:Individual
Prefix:DR
First Name:AZEEM
Middle Name:Z
Last Name:VASI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 BROWN DR
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:OH
Mailing Address - Zip Code:43506-8959
Mailing Address - Country:US
Mailing Address - Phone:419-636-4317
Mailing Address - Fax:
Practice Address - Street 1:405 W. GRAND AVE.
Practice Address - Street 2:GRANDVIEW HOSPITAL AND MEDICAL CENTER- MEDICAL EDUCATIO
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405
Practice Address - Country:US
Practice Address - Phone:937-723-3248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58.002750207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery