Individual
MOHAMMED AKHLACK HOSSAIN MAZUMDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
92 PICKETT LN, PRESTONSBURG, KY 41653-8569
(606) 874-0112
(606) 874-0115
Mailing address
742 OLD 114, APT # 2, PRESTONSBURG, KY 41653-8300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01068828A.
IN
207Q00000X
Family Medicine Physician
Primary
43704
KY
207Q00000X
Family Medicine Physician
MT194879
PA
363LP2300X
Primary Care Nurse Practitioner
43704
KY
Other
Enumeration date
05/21/2009
Last updated
08/22/2018
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