Organization
SHAZE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYED Q KAZMI MD (PRESIDENT)
(812) 282-2218
Entity
Organization
Contact information
Practice address
1035 WALL STREET STE 104-C1, JEFFERSONVILLE, IN 47130-3602
(812) 282-2218
(812) 282-2252
Mailing address
1035 WALL STREET STE 104-C1, JEFFERSONVILLE, IN 47130-3602
(812) 282-2218
(812) 282-2252
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300023539
—
IN
Enumeration date
02/26/2019
Last updated
08/15/2019
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