Healthcare Provider Details

I. General information

NPI: 1487483533
Provider Name (Legal Business Name): CAZIMA HAMIDOVIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 PLEASANT ST
CONCORD NH
03301-2551
US

IV. Provider business mailing address

264 PLEASANT ST
CONCORD NH
03301-2551
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-3368
  • Fax: 603-228-7268
Mailing address:
  • Phone: 603-224-3368
  • Fax: 603-228-7268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2989
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: