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General NPI Number Information
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NPI Number | 1205024197
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Entity Type | Organization
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Legal Business Name | HARBOR INFECTIOUS DISEASES
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 10/05/2007
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Provider Practice Location Address
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Address Line | 1730 GRAVES AVE
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City | ABERDEEN
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State | WA
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Zip | 98520-1213
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Country | US
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Telephone | 360-532-2311
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Fax |
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Provider Business Mailing Address
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Address Line | 1730 GRAVES AVE
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City | ABERDEEN
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State | WA
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Zip | 98520-1213
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MUHAMMAD AIJAZ KHURSHID
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Credential | M.D.
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Telephone | 360-532-2311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | MD 00038534
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License Number State | WA
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