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General NPI Number Information
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NPI Number | 1245534791
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Entity Type | Organization
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Legal Business Name | WYOMING COUNTY MEDICAL P.C.
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Dates
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Enumeration Date | 12/27/2010
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Last Update Date | 12/27/2010
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Provider Practice Location Address
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Address Line | 400 N MAIN ST
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City | WARSAW
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State | NY
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Zip | 14569-1025
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Country | US
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Telephone | 585-786-8940
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Fax |
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Provider Business Mailing Address
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Address Line | 50 ALCONA AVE
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City | AMHERST
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State | NY
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Zip | 14226-2201
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Country | US
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Telephone | 716-834-1193
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Fax | 716-834-1382
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Authorized Official
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Title or Position | PRESIDENT
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Name | MUSHTAQ KHAN
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Credential | M.D.
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Telephone | 716-689-4030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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