Provider Demographics
NPI:1407297823
Name:WAZIR, SHOAIB MUHAMMAD (MD)
Entity type:Individual
Prefix:
First Name:SHOAIB
Middle Name:MUHAMMAD
Last Name:WAZIR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 CALIBRE XING NW STE 1126
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-4104
Mailing Address - Country:US
Mailing Address - Phone:470-227-8130
Mailing Address - Fax:470-747-7588
Practice Address - Street 1:4450 CALIBRE XING NW STE 1126
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-4104
Practice Address - Country:US
Practice Address - Phone:470-227-8130
Practice Address - Fax:470-747-7588
Is Sole Proprietor?:No
Enumeration Date:2013-07-14
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA103967207RN0300X
AZ64012207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ262200Medicaid