Provider Demographics
NPI:1861602542
Name:AZAM, HAMAD (MBBS , MD)
Entity type:Individual
Prefix:DR
First Name:HAMAD
Middle Name:
Last Name:AZAM
Suffix:
Gender:M
Credentials:MBBS , MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 TWINLEAF RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52411-9519
Mailing Address - Country:US
Mailing Address - Phone:973-968-9685
Mailing Address - Fax:
Practice Address - Street 1:115 8TH ST NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-1013
Practice Address - Country:US
Practice Address - Phone:319-363-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA40679207RP1001X
IA406207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine