MEDICARE: AZIZKHAN INTERNAL MEDICINE ASSOCIATES

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	207R00000X	Internal Medicine Physician

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	:	1982666731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AZIZKHAN INTERNAL MEDICINE ASSOCIATES

Provider Business Mailing Address
First Line	:	888 POPLAR CHURCH RD
Second Line	:
City	:	CAMP HILL
State	:	PA
Zip	:	17011-2205
Country	:	US
Telephone Number	:	717-724-2126
Fax Number	:	717-724-2132

Provider Business Practice Location Address
First Line	:	888 POPLAR CHURCH RD
Second Line	:
City	:	CAMP HILL
State	:	PA
Zip	:	17011-2205
Country	:	US
Telephone Number	:	717-724-2126
Fax Number	:	717-724-2132

Authorized Official
Title or Position	:	PRESIDENT
Name	:	REZA G AZIZKHAN JR.
Credential	:	D.O.
Telephone Number	:	717-724-2126

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	01/15/2010

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