Provider Demographics
NPI:1972579118
Name:NAZIR, JAWAD (MD)
Entity type:Individual
Prefix:
First Name:JAWAD
Middle Name:
Last Name:NAZIR
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 1:6709 S MINNESOTA AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2592
Mailing Address - Country:US
Mailing Address - Phone:605-322-7250
Mailing Address - Fax:605-331-6401
Practice Address - Street 1:6709 S MINNESOTA AVE STE 102
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2593
Practice Address - Country:US
Practice Address - Phone:605-322-7250
Practice Address - Fax:605-332-7251
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5172207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0566026Medicaid
SD6004570Medicaid
SD4996034OtherBCBS
MN65260800Medicaid
SD6004570Medicaid
SD4996034OtherBCBS
SDP00035075Medicare ID - Type UnspecifiedRAILROAD