Provider Demographics
NPI:1104927797
Name:UMERANI, AJAZ (MD)
Entity type:Individual
Prefix:DR
First Name:AJAZ
Middle Name:
Last Name:UMERANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-1368
Mailing Address - Country:US
Mailing Address - Phone:937-325-3830
Mailing Address - Fax:937-398-0878
Practice Address - Street 1:2121 E HIGH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-1368
Practice Address - Country:US
Practice Address - Phone:937-325-3830
Practice Address - Fax:937-398-0878
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35071757207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2010693Medicaid
OHUM0865781Medicare ID - Type Unspecified
OH2010693Medicaid