# DR. MUMTAZ MOHIDIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1689625253
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 184482 | NY | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 184482 | NY | Yes |

## Other

- **Enumeration date:** 05/16/2006
- **Last updated:** 11/05/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 184482 | LICENSE | NY |
| 01 | — | 2511488 | GHI | NY |
| 01 | — | 3X1011 | EMPIRE BCBS | NY |