| Shaze Medical Group Llc | |
|
1035 Wall Street Ste 104-c1 Jeffersonville IN 47130-3602 | |
| (812) 282-2218 | |
| (812) 282-2252 |
| Full Name | Shaze Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1035 Wall Street Ste 104-c1, Jeffersonville, Indiana |
| Authorized Official Name and Position | Syed Q Kazmi (PRESIDENT) |
| Authorized Official Contact | 8122822218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaze Medical Group Llc 1035 Wall Street Ste 104-c1 Jeffersonville IN 47130-3602 Ph: (812) 282-2218 | Shaze Medical Group Llc 1035 Wall Street Ste 104-c1 Jeffersonville IN 47130-3602 Ph: (812) 282-2218 |
| NPI Number | 1245797208 |
|---|---|
| Provider Enumeration Date | 02/26/2019 |
| Last Update Date | 08/15/2019 |
| Medicare PECOS PAC ID | 7113267212 |
|---|---|
| Medicare Enrollment ID | O20190328000649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245797208 | NPI | - | NPPES |
| 300023539 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Syed Q Kazmi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487619888 PECOS PAC ID: 2567367790 Enrollment ID: I20040326000022 |
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