Provider Demographics
NPI:1306062633
Name:QAZI A. JAMIL, MD INC
Entity type:Organization
Organization Name:QAZI A. JAMIL, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:QAZI
Authorized Official - Middle Name:A
Authorized Official - Last Name:JAMIL
Authorized Official - Suffix:
Authorized Official - Credentials:MMD
Authorized Official - Phone:814-362-6911
Mailing Address - Street 1:24 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-1280
Mailing Address - Country:US
Mailing Address - Phone:814-362-6911
Mailing Address - Fax:
Practice Address - Street 1:24 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-1280
Practice Address - Country:US
Practice Address - Phone:814-362-6911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035984L207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty