Healthcare Provider Details

I. General information

NPI: 1427637479
Provider Name (Legal Business Name): MUHAMMAD AWAIS ASHRAF DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 FARMINGTON AVE
FARMINGTON CT
06030-2803
US

IV. Provider business mailing address

71 HAYNES ST
MANCHESTER CT
06040-4188
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-2784
  • Fax: 860-679-4126
Mailing address:
  • Phone: 860-533-4679
  • Fax: 860-645-4151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number111078
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number75929
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: