Healthcare Provider Details

I. General information

NPI: 1720951072
Provider Name (Legal Business Name): MUHAMMAD IQBAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 FRANKLIN ST
WATERBURY CT
06706-1253
US

IV. Provider business mailing address

47 SHARON RD
WATERBURY CT
06705-4054
US

V. Phone/Fax

Practice location:
  • Phone: 203-709-6424
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: