Healthcare Provider Details
I. General information
NPI: 1053841320
Provider Name (Legal Business Name): YAR MUHAMMAD RASUL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/19/2017
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
271 CAREW ST
SPRINGFIELD MA
01104-2377
US
IV. Provider business mailing address
271 CAREW ST
SPRINGFIELD MA
01104-2377
US
V. Phone/Fax
- Phone: 413-748-9349
- Fax: 413-452-6080
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 76457 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 282099 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: