Muhammad Waqar Azeem, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

40632 Issued in MN

Practice address

11705 State Ave
Brainerd, MN 56401-7307

Phone

(218) 330-1345

Fax

(218) 825-2182

NPI assigned

Feb 7, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1396885646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13916 GRAND OAKS CT",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564257932",
            "telephone_number": "218-330-1345",
            "fax_number": "218-825-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11705 STATE AVE",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564017307",
            "telephone_number": "218-330-1345",
            "fax_number": "218-825-2182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZEEM",
        "first_name": "MUHAMMAD",
        "middle_name": "WAQAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MN",
            "license": "40632",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A71833",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "204968",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Miranda Aulie, LICSW
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• Audriana Bagwell, LICSW
• Camellia Ranee Bailey, RN
• Abigail Ann Baillif, CNP
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• Child & Adolescent Psychiatry Physician in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Child & Adolescent Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.