MEDICARE: DR. SYED MUSTAFA 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
1	207RP1001X	Pulmonary Disease Physician	E-11601	AR
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	E-11601	AR

General Provider Information

NPI Number	:	1326393885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYED MUSTAFA MD

Provider Business Mailing Address
First Line	:	1 MERCY LN STE 401
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6441
Country	:	US
Telephone Number	:	501-623-5220
Fax Number	:	501-623-1546

Provider Business Practice Location Address
First Line	:	1 MERCY LN STE 401
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6441
Country	:	US
Telephone Number	:	501-623-5220
Fax Number	:	501-623-1546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2012
Last Update Date	:	03/08/2023

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