Healthcare Provider Details

I. General information

NPI: 1689294175
Provider Name (Legal Business Name): HAMZA AFTAB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 09/05/2023
Certification Date: 04/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MARTIN LUTHER KING JR WAY
TACOMA WA
98405
US

IV. Provider business mailing address

315 MARTIN LUTHER KING JR WAY
TACOMA WA
98405
US

V. Phone/Fax

Practice location:
  • Phone: 716-423-4178
  • Fax:
Mailing address:
  • Phone: 716-423-4178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.MD.61420326
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD.MD.61420326
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: