Healthcare Provider Details

I. General information

NPI: 1063947695
Provider Name (Legal Business Name): MUHAMMAD MOHSIN MUNAWAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date: 11/27/2017
Reactivation Date: 12/07/2017

III. Provider practice location address

1701 VETERANS DR
FLORENCE AL
35630-4928
US

IV. Provider business mailing address

1701 VETERANS DR
FLORENCE AL
35630-4928
US

V. Phone/Fax

Practice location:
  • Phone: 256-629-1000
  • Fax:
Mailing address:
  • Phone: 256-629-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD.51422
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: