Provider Demographics
NPI:1689691545
Name:GHAZI, MAJID (MD)
Entity type:Individual
Prefix:
First Name:MAJID
Middle Name:
Last Name:GHAZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 41ST ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-7783
Mailing Address - Country:US
Mailing Address - Phone:701-551-6980
Mailing Address - Fax:701-551-6984
Practice Address - Street 1:2401 41ST ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-7783
Practice Address - Country:US
Practice Address - Phone:701-551-6980
Practice Address - Fax:701-551-6984
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2016-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND9776208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H92680Medicare UPIN