MEDICARE: DR. SALMAN M MUDDASSIR M.D.

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
1	207R00000X	Internal Medicine Physician	25MA08169300	NJ
2	208M00000X	Hospitalist Physician	ME122573	FL
3	207R00000X	Internal Medicine Physician	ME122573	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	261649038	OTHER		HORIZON BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	3840780	OTHER		COVENTRY & FIRST HEALTH
4	60082604	OTHER	NJ	HORIZON NJ HEALTH
5	3580249000	OTHER		KEYSTONE HEALTH PLAN EAST PCP
6	05200993	OTHER		CIGNA
7	3580249000	OTHER	NJ	AMERIHEALTH
8	9474147	OTHER		AETNA PPO
9	6441184	OTHER		AETNA HMO PCP
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578608220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SALMAN M MUDDASSIR M.D.

Provider Business Mailing Address
First Line	:	14690 SPRING HILL DR STE 305
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-8102
Country	:	US
Telephone Number	:	352-277-5348
Fax Number	:	352-606-2857

Provider Business Practice Location Address
First Line	:	9030 W FORT ISLAND TRL STE 1
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-8011
Country	:	US
Telephone Number	:	352-228-8906
Fax Number	:	352-228-8905

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	05/31/2023

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