Healthcare Provider Details

I. General information

NPI: 1669331625
Provider Name (Legal Business Name): MUHAMMAD ASAD SHABBIR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 18TH ST E
TIFTON GA
31794-3648
US

IV. Provider business mailing address

1015 PARK AVE N APT 11
TIFTON GA
31794-6973
US

V. Phone/Fax

Practice location:
  • Phone: 229-353-4506
  • Fax:
Mailing address:
  • Phone: 732-697-8676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP140411
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: