Imam, Azhar
Imam, Azhar is an individual health care provider with primary practice located at 100 Jefferson Square , Waterbury CT 06706-1253. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Imam, Azhar can be contacted via phone (203) 709-6200.Contact Information
Primary practice address
100 Jefferson Square
Waterbury CT 06706-1253
Phone: (203) 709-6200
Fax: (203) 709-3335
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 042814 | Connecticut |
Profile Details
| NPI number | 1578516597 |
|---|---|
| LBN Legal business name | Imam, Azhar |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 19th, 2006 |
| Last updated | Oct 19th, 2011 - about 13 years 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 | 1578516597 | NPPES |
| Connecticut | MEDICAID | 001428144 |
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