Healthcare Provider Details

I. General information

NPI: 1114970969
Provider Name (Legal Business Name): INFECTIOUS DISEASES AND TRAVEL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 MARY ST STE 230
EVANSVILLE IN
47710-1678
US

IV. Provider business mailing address

PO BOX 3276
EVANSVILLE IN
47731-3276
US

V. Phone/Fax

Practice location:
  • Phone: 812-450-8600
  • Fax: 812-450-8151
Mailing address:
  • Phone: 812-450-8600
  • Fax: 812-450-8151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MUBASHIR A ZAHID
Title or Position: SOLE OWNER
Credential: M.D.
Phone: 812-491-1328