MEDICARE: DR. AMER M. KAZI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	01059304A	IN
2	208VP0000X	Pain Medicine Physician	01059304A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000576523	OTHER	IN	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134122914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMER M. KAZI M.D.

Provider Business Mailing Address
First Line	:	6915 N FIR RD
Second Line	:
City	:	GRANGER
State	:	IN
Zip	:	46530-4754
Country	:	US
Telephone Number	:	574-234-2191
Fax Number	:	574-234-7720

Provider Business Practice Location Address
First Line	:	6915 N FIR RD
Second Line	:
City	:	GRANGER
State	:	IN
Zip	:	46530-4754
Country	:	US
Telephone Number	:	574-234-2191
Fax Number	:	574-231-7720

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	02/25/2020

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