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Individual

SAFWAN KAZMOUZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
40 HIBISCUS WAY, NASHUA, NH 03062-3088
(734) 718-0196
Mailing address
40 HIBISCUS WAY, NASHUA, NH 03062-3088
(734) 718-0196

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
14925
NH
207QG0300X
Geriatric Medicine (Family Medicine) Physician
4301062135
MI
261Q00000X
Clinic/Center
A65580
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0808272492
BLUE CROSS BLUE SHIELD
MI
05
3095219
NH
05
4123626
MI
Enumeration date
07/07/2005
Last updated
08/01/2024
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