Provider Demographics
NPI:1154582161
Name:AZAD, NAZAR HUSSAIN (MD)
Entity type:Individual
Prefix:
First Name:NAZAR
Middle Name:HUSSAIN
Last Name:AZAD
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 1:19137 RED OAK LN
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48193-8804
Mailing Address - Country:US
Mailing Address - Phone:734-576-5641
Mailing Address - Fax:
Practice Address - Street 1:19137 RED OAK LN
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:MI
Practice Address - Zip Code:48193-8804
Practice Address - Country:US
Practice Address - Phone:734-576-5641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2016-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075427208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice