Individual
DR. AMINA S QAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO, PHARMD
Contact information
Practice address
360 BROADWAY, BANGOR, ME 04401-3979
(207) 907-1770
(207) 907-3675
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8560
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
DO2061
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000781002
MEDICARE PTAN
ME
Enumeration date
11/23/2006
Last updated
02/03/2022
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