Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI Number | 1952718140 |
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| LBN Legal business name | MUDASSIR NAWAZ M.D. CLINIC | ||||
| Authorized official | TERRI HERRIAN - (NURSE PRACTITIONER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 07/19/2014 | ||||
| Last updated | 07/19/2014 - About 12 years ago | ||||
| Identifiers |
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