Healthcare Provider Details

I. General information

NPI: 1588300065
Provider Name (Legal Business Name): ADAM MANZOOR QAZI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 HOSPITAL DR STE 106
HOLYOKE MA
01040-6612
US

IV. Provider business mailing address

10 HOSPITAL DR STE 106
HOLYOKE MA
01040-6612
US

V. Phone/Fax

Practice location:
  • Phone: 413-539-6830
  • Fax: 413-538-6003
Mailing address:
  • Phone: 413-539-6830
  • Fax: 413-538-6003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1022463
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351049735
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: