Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 36152 | AZ |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 38152 | AZ |
N | 207VG0400X | Gynecologist | 38152 | AZ |
NPI | 1881810224 |
---|---|
Provider Name | Dr. Ali Azadi |
First Address | Phoenix, AZ 85050-5463 |
Second Address | Peoria, AZ 85381 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 09/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000610828 | ANTHEM (01) | KY |
000000610873 | ANTHEM (01) | KY |
000000859185 | ANTHEM-WS (01) | KY |
0722553 | MEDICARE - FOUNDATION (01) | KY |
158647 | SIHO-WS (01) | KY |
200943770 | (05) | IN |
335673 | (05) | AZ |
3726870000 | PASSPORT ADVANTAGE SPECIALITY (01) | KY |
3726874000 | PASSPORT ADVANTAGE PCP (01) | KY |
3726876000 | PASSPORT ADVANTAGE (01) | KY |
50024900 | PASSPORT SPECIALITY (01) | KY |
50024904 | PASSPORT PCP (01) | KY |
50024906 | PASSPORT SPECIALITY (01) | KY |
50069587 | PASSPORT-WS (01) | KY |
7100074140 | (05) | KY |
9393153 | AETNA (01) | KY |