DR. AZRIEL AVEZBADALOV (NPI# 1376833129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376833129 |
| Entity Type | Individual |
| Full Name | DR. AZRIEL AVEZBADALOV |
| Credential | D.O. |
| Practice Address |
7950 W Jefferson Blvd Fort Wayne IN 46804-4140 |
| Mailing Address |
6920 Pointe Inverness Way Ste 200 Fort Wayne IN 46804-7934 |
| Practice Telephone | 2604322297 |
| Practice Fax Number | 2604346433 |
| Mailing Telephone | 2604793514 |
| Mailing Fax Number | 2604793520 |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2020-09-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
02005736A | IN | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
OS13717 | FL | Allopathic & Osteopathic Physicians |
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
72069 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | MEDICARE | 260690286 | 01 |
| FL | 018825600 | 05 | |
| FL | MEDICARE | PENDING | 01 |
| IN | 300029932 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1223 Gateway Dr Ste 2e, Melbourne, FL 329012607 | 3214346650 | 3214345867 |
| 8725 N Wickham Rd Ste 302, Melbourne, FL 329402240 | 3214346650 | 3214345867 |
| 255 Borman Dr Fl 2, Merritt Island, FL 329533486 | 3214346650 | 3214345867 |
| Street Address |
7950 W JEFFERSON BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-4140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760486187 | Heather J. Wolfe | Pediatrics | 7950 W Jefferson Blvd, Suite 212, Fort Wayne, IN 46804-4140 | 2005-06-13 |
| 1831798354 | Dorian Raymone Tate | Nurse Anesthetist, Certified Registered | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-10-26 |
| 1528665585 | Alexis Kate Felger | Nurse Practitioner | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-10-02 |
| 1114534054 | Mary Catherine Richter | Specialist/Technologist, Other | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2020-09-24 |
| 1538778386 | Lori Elizabeth Jackson | Registered Nurse | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2020-07-28 |
| 1831708965 | Anna N. Kemler | Nurse Practitioner | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-07-24 |
| 1699383307 | David James Mansfield | Registered Nurse | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-07-20 |
| 1932726452 | Joseph Egbert | Registered Nurse | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-06-30 |
| 1245851872 | Lauren Tirey | Occupational Therapist | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2020-05-05 |
| 1609415421 | Mikhaila Sailor | Dietitian, Registered | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2019-12-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780919886 | Heart Care LLC | Internal Medicine | 7806 W Jefferson Blvd, Suite D, Fort Wayne, IN 46804-4180 | 2009-10-07 |
| 1003078312 | Dustin M Thomas | Internal Medicine | 11108 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2008-06-27 |
| 1174625065 | Baltes Cardiology | Internal Medicine | 821 Broadway, Fort Wayne, IN 46802-2107 | 2006-09-02 |
| 1922117571 | Louis Alfred Lopez | Internal Medicine | 604 W Berry St, Fort Wayne, IN 46802-2106 | 2006-08-29 |
| 1821068511 | Subhash Reddy | Internal Medicine | 7806 W Jefferson Blvd Ste D, Fort Wayne, IN 46804-4180 | 2006-01-25 |
| 1215917844 | Gary A. Hambel | Internal Medicine | 11108 Parkview Circle Dr., Fort Wayne, IN 46845-1730 | 2006-01-19 |
| 1932199627 | J. Rod Gimbel | Internal Medicine | 7910 W Jefferson Blvd Ste 120, Fort Wayne, IN 46804-4159 | 2005-10-25 |
| 1568464972 | Raymond E Dusman Jr. | Internal Medicine | 1819 Carew St, Fort Wayne, IN 46805-4705 | 2005-08-15 |
| 1427058825 | Motaz Shaher | Internal Medicine | 7916 W Jefferson Blvd, Fort Wayne, IN 46804 | 2005-07-28 |
| 1710986443 | Lawrence E Gering | Internal Medicine | 11108 Parkview Circle Dr, Fort Wayne, IN 46845-1730 | 2005-07-15 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on DR. AZRIEL AVEZBADALOV.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.