MEDICARE: DR. HASHIM MOHAMMAD YUSUFZAI 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	35053716	OH
2	207Q00000X	Family Medicine Physician	0101237172	VA

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	:	1669466926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HASHIM MOHAMMAD YUSUFZAI MD

Provider Business Mailing Address
First Line	:	PO BOX 308
Second Line	:
City	:	DUNCAN FALLS
State	:	OH
Zip	:	43734-0308
Country	:	US
Telephone Number	:	740-674-5020
Fax Number	:	740-674-5080

Provider Business Practice Location Address
First Line	:	488 MAPLE ST
Second Line	:
City	:	DUNCAN FALLS
State	:	OH
Zip	:	43734-9751
Country	:	US
Telephone Number	:	740-674-5020
Fax Number	:	740-674-5080

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

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	07/08/2007

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