MEDICARE: DR. MUHAMMAD AYUB 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	207Q00000X	Family Medicine Physician	MD00044810	WA

General Provider Information

NPI Number	:	1386641694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MUHAMMAD AYUB MD

Provider Business Mailing Address
First Line	:	9040 FITZSIMMONS DRIVE
Second Line	:	MADIGAN ARMY MEDICAL CENTER
City	:	FORT LEWIS
State	:	WA
Zip	:	98431
Country	:	US
Telephone Number	:	253-968-5779
Fax Number	:	253-968-1678

Provider Business Practice Location Address
First Line	:	9040 JACKSON AVE MADIGAN ARMY MEDICAL CENTER
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98431-0001
Country	:	US
Telephone Number	:	253-968-5779
Fax Number	:	253-968-1678

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	11/19/2019

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