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NPI Code Detail

MEDICARE: MOFIZ HAQUE M.D.

MEDICARE: MOFIZ HAQUE 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
1207P00000XEmergency Medicine Physician35-086799OH
2207R00000XInternal Medicine PhysicianA80316CA

Other Identifiers

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

General Provider Information

NPI Number : 1811967375
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOFIZ HAQUE M.D.
Provider Business Mailing Address
First Line : PO BOX 65274
Second Line :
City : CHARLOTTE
State : NC
Zip : 28265-0274
Country : US
Telephone Number : 800-377-8721
Fax Number : 304-523-2241
Provider Business Practice Location Address
First Line : 2000 VALE RD
Second Line :
City : SAN PABLO
State : CA
Zip : 94806-3808
Country : US
Telephone Number : 510-235-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 09/28/2007

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