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General NPI Number Information
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NPI Number | 1881968188
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Entity Type | Individual
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Provider Name | FAHAD AZIZ M.D
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Gender | Male
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Dates
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Enumeration Date | 03/05/2012
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Last Update Date | 02/03/2021
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Provider Practice Location Address
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Address Line | 3034 FISH HATCHERY RD
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City | FITCHBURG
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State | WI
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Zip | 53713-3125
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Country | US
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Telephone | 608-270-5656
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Fax |
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Provider Business Mailing Address
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Address Line | 7974 UW HEALTH CT
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City | MIDDLETON
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State | WI
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Zip | 53562-5531
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2014029667
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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 | 64948
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2012-01401
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 64948
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License Number State | WI
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