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General NPI Number Information
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NPI Number | 1306839196
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Entity Type | Organization
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Legal Business Name | ABDUL NAUSHAD MD PC
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 03/08/2017
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Provider Practice Location Address
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Address Line | 2865 JAMES BLVD
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-2803
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Country | US
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Telephone | 636-638-1506
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Fax | 636-638-1507
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Provider Business Mailing Address
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Address Line | 622 COLLINS DR STE. 200
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City | FESTUS
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State | MO
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Zip | 63028-2077
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Country | US
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Telephone | 636-638-1506
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Fax | 636-638-1507
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ABDUL N NAUSHAD
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Credential | M.D.
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Telephone | 636-638-1506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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