Healthcare Provider Details

I. General information

NPI: 1316170640
Provider Name (Legal Business Name): NAUSHAD HAZIQ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2009
Last Update Date: 09/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 6TH AVE
HUNTINGTON WV
25701-2104
US

IV. Provider business mailing address

612 6TH AVE
HUNTINGTON WV
25701-2104
US

V. Phone/Fax

Practice location:
  • Phone: 304-525-4202
  • Fax: 304-525-4231
Mailing address:
  • Phone: 304-525-4202
  • Fax: 304-525-4231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number336014535
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberTP751
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: