Healthcare Provider Details

I. General information

NPI: 1104055326
Provider Name (Legal Business Name): MUHAMMAD ASIF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 09/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 FOSTER LANE SUITE 201
WARRENSBURG MO
64093-3239
US

IV. Provider business mailing address

403 BURKARTH RD
WARRENSBURG MO
64093-3101
US

V. Phone/Fax

Practice location:
  • Phone: 660-262-7415
  • Fax: 660-262-7416
Mailing address:
  • Phone: 660-262-7415
  • Fax: 660-262-7416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC1-0010269
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD447814
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2015010240
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: