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General NPI Number Information
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NPI Number | 1003949868
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Entity Type | Organization
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Legal Business Name | ENDOCRINOLOGY & DIABETES CARE CENTER PA
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 12/03/2013
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Provider Practice Location Address
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Address Line | 3226 COVE BEND DR
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City | TAMPA
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State | FL
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Zip | 33613-2752
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Country | US
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Telephone | 813-977-0778
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Fax | 813-977-2685
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Provider Business Mailing Address
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Address Line | 3226 COVE BEND DR
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City | TAMPA
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State | FL
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Zip | 33613-2752
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Country | US
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Telephone | 813-977-0778
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Fax | 813-977-2685
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MOHAMMAD MUJAHID BAIG
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Credential | M.D.
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Telephone | 813-977-0778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME 72784
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License Number State | FL
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