Provider Demographics
NPI:1962589176
Name:KAZEMY, ABDUL HAI (MD)
Entity type:Individual
Prefix:
First Name:ABDUL
Middle Name:HAI
Last Name:KAZEMY
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 1:1663 WATER ST NE
Mailing Address - Street 2:67
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97303-6688
Mailing Address - Country:US
Mailing Address - Phone:503-220-8262
Mailing Address - Fax:
Practice Address - Street 1:1660 OAK ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-6942
Practice Address - Country:US
Practice Address - Phone:503-220-8262
Practice Address - Fax:503-316-8817
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD25197207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine