Individual
TASADUQ N FAZILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 CRYSTAL SPRING AVE SW STE 301, ROANOKE, VA 24014-2465
(540) 981-7715
Mailing address
2001 CRYSTAL SPRING AVE SW STE 301, ROANOKE, VA 24014-2465
(540) 981-7715
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
0101267456
VA
207RI0200X
Infectious Disease Physician
261497
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03361800
—
NY
01
—
P01227409
RAILROAD MEDICARE
NY
Enumeration date
05/23/2006
Last updated
05/19/2022
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