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General NPI Number Information
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NPI Number | 1902005812
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Entity Type | Organization
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Legal Business Name | COBBLER STATION INTERNISTS
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 5130 CHARLESTOWN RD STE 1 SUITE 1
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City | NEW ALBANY
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State | IN
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Zip | 47150-9483
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Country | US
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Telephone | 812-949-0140
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Fax | 812-949-0279
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Provider Business Mailing Address
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Address Line | 5130 CHARLESTOWN RD SUITE 1
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City | NEW ALBANY
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State | IN
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Zip | 47150-9483
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Country | US
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Telephone | 812-949-0140
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Fax | 812-949-0279
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SYED Q KAZMI
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Credential | M.D.
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Telephone | 812-949-0140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01044505A
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License Number State | IN
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