MEDICARE: AZMI DRAW MD

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	207RP1001X	Pulmonary Disease Physician	26883	KY
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	36883	KY
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	36883	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801878806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AZMI DRAW MD

Provider Business Mailing Address
First Line	:	10214 WORTHINGTON LN
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-8551
Country	:	US
Telephone Number	:	502-216-0191
Fax Number	:

Provider Business Practice Location Address
First Line	:	10214 WORTHINGTON LN
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-8551
Country	:	US
Telephone Number	:	502-216-0191
Fax Number	:

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

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	01/19/2015

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Directions to “ AZMI DRAW MD” Practice Location

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