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NPI Code Detail

MEDICARE: DR. MUHAMMAD B BOSTAJI M.D.

MEDICARE: DR. MUHAMMAD B BOSTAJI M.D.
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
1207RP1001XPulmonary Disease PhysicianMD12302RI
2207RP1001XPulmonary Disease Physician01089891AIN

General Provider Information

NPI Number : 1609875046
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MUHAMMAD B BOSTAJI M.D.
Provider Business Mailing Address
First Line : PO BOX 834
Second Line :
City : GOSHEN
State : IN
Zip : 46527-0834
Country : US
Telephone Number : 574-364-2592
Fax Number :
Provider Business Practice Location Address
First Line : 200 HIGH PARK AVE
Second Line :
City : GOSHEN
State : IN
Zip : 46526-4810
Country : US
Telephone Number : 574-364-2888
Fax Number : 574-364-2327
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 08/08/2023

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