Individual provider · NPI-1

Nosheen Azam, M.D.

Family Medicine · Waycross, GA

NPI number1184852600
StatusActive
Last updated in NPPESJan 22, 2013

Details

NPI
1184852600
Entity type
Individual (NPI-1)
Name
Nosheen Azam
Credential
M.D.
Sex
Female
Sole proprietor
No
Enumeration date
Jun 23, 2009
Last updated
Jan 22, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine003585GAYes

Practice location

808 Beacon St
Waycross, GA 31501-7104

Phone 706-721-3157

Mailing address

Po Box 173
Waycross, GA 31502-0173

Phone 912-490-0722

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