Healthcare Provider Details

I. General information

NPI: 1033663901
Provider Name (Legal Business Name): MUHAMMAD ATHAR KHAWAJA MBBS,FCPS,M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2016
Last Update Date: 08/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

6228 CROOKED CREEK DR
MASON OH
45040-2444
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-6001
  • Fax: 513-558-8689
Mailing address:
  • Phone: 513-817-5565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberOH 57.028877
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: