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General NPI Number Information
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NPI Number | 1598373987
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Entity Type | Individual
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Provider Name | KOMAL MUSHTAQ MD
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Gender | Female
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Dates
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Enumeration Date | 07/21/2020
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Last Update Date | 09/07/2025
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Provider Practice Location Address
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Address Line | 2049 E 100TH ST
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City | CLEVELAND
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State | OH
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Zip | 44106-2104
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Country | US
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Telephone | 216-444-2606
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Fax | 216-636-7871
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Provider Business Mailing Address
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Address Line | 2049 E 100TH ST
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City | CLEVELAND
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State | OH
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Zip | 44106-2104
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Country | US
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Telephone |
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Fax | 216-636-7871
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 35.146679
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 35.146679
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License Number State | OH
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