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General NPI Number Information
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NPI Number | 1255409082
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Entity Type | Organization
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Legal Business Name | TRI-STATE HEALTH, INC.
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 107 N BRIDGE ST
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City | ELKTON
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State | MD
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Zip | 21921-5326
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Country | US
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Telephone | 410-392-6408
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Fax | 410-392-6409
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Provider Business Mailing Address
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Address Line | 107 N BRIDGE ST
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City | ELKTON
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State | MD
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Zip | 21921-5326
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Country | US
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Telephone | 410-392-6408
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Fax | 410-392-4809
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Authorized Official
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Title or Position | OWNER
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Name | MUHAMMED A NIAZ
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Credential | M.D.
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Telephone | 410-392-6408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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