Provider Demographics
NPI:1720827306
Name:AZIZ, ABDUL A
Entity type:Individual
Prefix:
First Name:ABDUL
Middle Name:A
Last Name:AZIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4265 NICOLS RD APT 408
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-1417
Mailing Address - Country:US
Mailing Address - Phone:507-351-1645
Mailing Address - Fax:
Practice Address - Street 1:4265 NICOLS RD APT 408
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-1417
Practice Address - Country:US
Practice Address - Phone:507-351-1645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program