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General NPI Number Information
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NPI Number | 1619196185
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Entity Type | Individual
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Provider Name | KHADER MUQTADIR M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 02/18/2022
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Provider Practice Location Address
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Address Line | 13905 BRUCE B DOWNS BLVD STE B
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City | TAMPA
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State | FL
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Zip | 33613-3998
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Country | US
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Telephone | 813-978-9494
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Fax | 813-979-4817
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Provider Business Mailing Address
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Address Line | 13905 BRUCE B DOWNS BLVD STE B
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City | TAMPA
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State | FL
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Zip | 33613-3998
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Country | US
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Telephone | 813-978-9494
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Fax | 813-979-4817
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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 | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | ME 98421
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License Number State | FL
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