Healthcare Provider Details

I. General information

NPI: 1902909229
Provider Name (Legal Business Name): MUHAMMAD SAQUIB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4082 PENDLETON WAY
INDIANAPOLIS IN
46226-5224
US

IV. Provider business mailing address

4082 PENDLETON WAY
INDIANAPOLIS IN
46226-5224
US

V. Phone/Fax

Practice location:
  • Phone: 317-546-1915
  • Fax: 317-546-1920
Mailing address:
  • Phone: 317-546-1915
  • Fax: 317-546-1920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01061150A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: