=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194031054
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HAMMAD LIAQUAT MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2010
-----------------------------------------------------
Last Update Date | 11/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4505 SAUCON CREEK RD # 200
-----------------------------------------------------
City | CENTER VALLEY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18034-8481
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-526-6545
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8003 CASTLEWAY DR
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46250-1946
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-576-1335
-----------------------------------------------------
Fax | 844-397-1311
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | 46972
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | MD464683
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 01077069A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------