Individual
SYED SHABAZ AZEEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 16TH AVE E, SEATTLE, WA 98112-5211
(206) 326-3000
Mailing address
125 16TH AVE E, SEATTLE, WA 98112-5211
(206) 326-3000
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
036111490
IL
207T00000X
Neurological Surgery Physician
Primary
C135229
CA
207T00000X
Neurological Surgery Physician
N0619
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03611490
—
IL
05
—
196952901
—
TX
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147137
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
P01144158
RAILROAD MEDICARE INDIVIDUAL PTAN
IL
Enumeration date
08/05/2008
Last updated
04/01/2021
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