=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720188113
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MUHAMMAD SARWAR PASHA MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/25/2006
-----------------------------------------------------
Last Update Date | 11/23/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 138 WEBSTER STREET ELLIOT SENIOR HEALTH CENTER
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-663-7030
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15 WINDING RD
-----------------------------------------------------
City | BEDFORD
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03110-5655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-471-2599
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number | 13225
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------