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NPI Code Detail

MEDICARE: MOHAMMED A HAQUE MD

MEDICARE: MOHAMMED A HAQUE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD052538-LPA

General Provider Information

NPI Number : 1083829477
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOHAMMED A HAQUE MD
Provider Business Mailing Address
First Line : 1101 E WELSH RD
Second Line :
City : MAPLE GLEN
State : PA
Zip : 19002-3036
Country : US
Telephone Number : 215-641-0192
Fax Number :
Provider Business Practice Location Address
First Line : 7901 STATE RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19136-3407
Country : US
Telephone Number : 215-685-7741
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2007
Last Update Date : 07/08/2007

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