Provider Demographics
NPI:1124463963
Name:HAFEEZ, WAQAR (MD)
Entity type:Individual
Prefix:
First Name:WAQAR
Middle Name:
Last Name:HAFEEZ
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 1:10299 SOUTHERN BLVD # 212773
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4337
Mailing Address - Country:US
Mailing Address - Phone:718-971-5133
Mailing Address - Fax:
Practice Address - Street 1:6071 WEST OUTER DRIVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-966-3189
Practice Address - Fax:313-966-1738
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2020-08-05
Deactivation Date:2014-03-27
Deactivation Code:
Reactivation Date:2014-05-06
Provider Licenses
StateLicense IDTaxonomies
OK355662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology