Active NPI
Azeem Haider, MD
- Student in an Organized Health Care Education/Training Program
- Philadelphia, PA
National Provider Identifier
1124765839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 5501 Old York Rd Ste 1
Philadelphia, PA 19141-3098 - Phone
- (201) 572-5246
- NPI assigned
- May 14, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MT229675 | PA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
5501 Old York Rd Ste 1
Philadelphia, PA 19141-3098
Mailing address
5501 Old York Rd Ste 1
Philadelphia, PA 19141-3098
Phone (201) 572-5246
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT229675 | PA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686960000000",
"number": "1124765839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5501 OLD YORK RD STE 1",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191413098",
"telephone_number": "201-572-5246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5501 OLD YORK RD STE 1",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191413098",
"telephone_number": "201-572-5246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAIDER",
"first_name": "AZEEM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-14",
"last_updated": "2023-06-17",
"certification_date": "2023-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "PA",
"license": "MT229675",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.