MEDICARE: DR. MUHAMMAD ISHFAQ 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
1	207R00000X	Internal Medicine Physician	ME116810	FL
2	207R00000X	Internal Medicine Physician	Q0941	TX
3	208M00000X	Hospitalist Physician	ME116810	FL

General Provider Information

NPI Number	:	1801236807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MUHAMMAD ISHFAQ M.D

Provider Business Mailing Address
First Line	:	1643 NW 136TH AVE BLDG H
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33323-2857
Country	:	US
Telephone Number	:	865-500-1345
Fax Number	:	865-560-7110

Provider Business Practice Location Address
First Line	:	2135 DENTON DR
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75006-3103
Country	:	US
Telephone Number	:	321-799-7111
Fax Number	:	865-560-7110

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

Provider Enumeration Date	:	07/05/2013
Last Update Date	:	03/11/2021

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