Individual
MAHNAZ QAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2622 LAKE AVE, FORT WAYNE, IN 46805-5410
(260) 425-3100
(260) 425-3604
Mailing address
2622 LAKE AVE, FORT WAYNE, IN 46805-5410
(260) 425-3100
(260) 425-3604
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01068402A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200985520
—
IN
Enumeration date
05/17/2007
Last updated
03/13/2015
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