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NPI Code Detail

MEDICARE: MUFADDAL M HASHIM MD

MEDICARE: MUFADDAL M HASHIM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianIL

General Provider Information

NPI Number : 1245283035
Entity Type Code : Individual
Provider Name (Legal Business Name) : MUFADDAL M HASHIM MD
Provider Business Mailing Address
First Line : 3600 E STATE ST
Second Line : SUITE 328
City : ROCKFORD
State : IL
Zip : 61108-1978
Country : US
Telephone Number : 815-397-5554
Fax Number : 815-397-0993
Provider Business Practice Location Address
First Line : 5666 E STATE ST
Second Line :
City : ROCKFORD
State : IL
Zip : 61108-2425
Country : US
Telephone Number : 815-395-5240
Fax Number : 815-227-2447
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 07/08/2007

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Directions to “ MUFADDAL M HASHIM MD” Practice Location

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