Healthcare Provider Details

I. General information

NPI: 1841788114
Provider Name (Legal Business Name): HAROON MUHAMMAD MUJAHID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 HENNESSY BLVD STE 701
BATON ROUGE LA
70808-4370
US

IV. Provider business mailing address

2160 S 1ST AVE RM 6292
MAYWOOD IL
60153-3328
US

V. Phone/Fax

Practice location:
  • Phone: 225-765-5864
  • Fax: 225-765-2013
Mailing address:
  • Phone: 708-216-5911
  • Fax: 708-327-2771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number30170
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number327639
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.173528
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number327639
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: