Avezbadalov, Azriel
Avezbadalov, Azriel is an individual health care provider with primary practice located at 7950 W Jefferson Blvd , Fort Wayne IN 46804-4140. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Avezbadalov, Azriel can be contacted via phone (260) 432-2297.Contact Information
Primary practice address
7950 W Jefferson Blvd
Fort Wayne IN 46804-4140
Phone: (260) 432-2297
Fax: (260) 434-6433
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | OS13717 | Florida |
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 72069 | Wisconsin |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 02005736A | Indiana |
Profile Details
| NPI number | 1376833129 |
|---|---|
| LBN Legal business name | Avezbadalov, Azriel |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 13th, 2011 |
| Last updated | May 31st, 2024 - about 7 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376833129 | NPPES |
| Florida | MEDICAID | 018825600 | |
| Florida | Other | 260690286 | |
| Florida | MEDICAID | 300029932 | |
| Florida | Other | PENDING |
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