Physician Compare National (NPI:1306850813)

HEALTHCARE PROVIDER:

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1306850813
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2264505783
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080716000802
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MUHAMMUD
	Individual professional last name
Provider First Name	FAQUIR
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1971
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	11155 DUNN RD 212
	Group Practice or individual's line 1 address
City	ST LOUIS
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	631366166
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	260180
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHRISTIAN HOSPITAL NORTHEAST
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	260005
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SSM ST JOSEPH HEALTH CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y