Shadi Fawzi Azar, MBBS
Individual provider Active NPI Diagnostic Radiology Physician · Ann Arbor, MI
NPI 1891987186 · NPPES record last updated Feb 22, 2012
Key facts
- NPI
- 1891987186
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 4301089689 (MI)
- Practice address
- 1500 East Medical Center Dr
B1 Floor University Hospital Recp C
Ann Arbor, MI 48109-5030 - Phone
- (734) 936-4566
- NPI assigned
- Aug 10, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Commonwealth Healthcare Corporation
Practice addresses (Care Compare)
1 Lower Navy Hill Rd
Saipan, MP 96950
Phone (670) 234-8950
1 Lower Navy Hill Rd
Saipan, MP 96950-0409
PO Box
Saipan, MP 96950
Hospital & facility affiliations
- Commonwealth Health Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MP
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251103003709 | MP | Practitioner - Diagnostic Radiology | 3779678248 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301089689 | MI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth Healthcare Corporation | Current |
Accepting new patients | |
| Commonwealth Healthcare Corporation | Current |
Accepting new patients | |
| Commonwealth Healthcare Corporation | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 4301089689 | MI | Yes |
Addresses
Primary practice location
1500 East Medical Center Dr
B1 Floor University Hospital Recp C
Ann Arbor, MI 48109-5030
Mailing address
3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047
Other providers in Ann Arbor, MI
- Kailah Rayne Ayres-Tuttle
- Kaitlyn Ayres
- Nicholas Ayres
- Rita N Ayyangar
- Adam Azar
- James N Azim
- Tanya Marlene Azizi
- Colleen A Azure
- Shams Zaher Azzawi
- Paige Baal
All providers in Ann Arbor, MI · Diagnostic Radiology Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.