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General NPI Number Information
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NPI Number | 1184289829
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Entity Type | Organization
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Legal Business Name | ST THOMAS CLINIC VHD LLC
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 5485 FIRETHORN PT
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City | SPRING HILL
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State | FL
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Zip | 34609-9512
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Country | US
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Telephone | 267-393-5265
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 15722
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City | BROOKSVILLE
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State | FL
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Zip | 34604-0123
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Country | US
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Telephone | 267-393-5265
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SALMAN MUDDASSIR
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Credential | MD
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Telephone | 267-393-5265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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