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General NPI Number Information
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NPI Number | 1821075672
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Entity Type | Individual
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Provider Name | MOHAMMAD ASIF WAZIRI M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2305 GERORGIA ST
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City | LOUISIANA
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State | MO
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Zip | 63353
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Country | US
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Telephone | 573-754-5531
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Fax |
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Provider Business Mailing Address
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Address Line | 147 GEMINI DR
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City | HANNIBAL
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State | MO
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Zip | 63401-2389
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Country | US
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Telephone | 573-248-8639
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2001010816
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2001010816
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License Number State | MO
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