Individual
AJAZ IQBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(206) 481-2700
Mailing address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(206) 481-2700
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0420009697
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OVN1777
—
VT
Enumeration date
12/18/2006
Last updated
04/26/2012
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