MEDICARE: MUBIN ISAAC SYED 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	2085R0204X	Vascular & Interventional Radiology Physician	35070207	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467438580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUBIN ISAAC SYED MD

Provider Business Mailing Address
First Line	:	1331 N ELM ST STE 200
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-6304
Country	:	US
Telephone Number	:	336-274-9617
Fax Number	:	336-482-2177

Provider Business Practice Location Address
First Line	:	3075 GOVERNORS PLACE BLVD
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45409-1323
Country	:	US
Telephone Number	:	937-765-3113
Fax Number	:

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

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	06/24/2016

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