Individual
DR. MOHAMMAD ALI KIZILBASH
Active
Individual
DR. MOHAMMAD ALI KIZILBASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036-111516
IL
207RC0000X
Cardiovascular Disease Physician
2009030104
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036111516
STATE LICENSE
IL
Enumeration date
12/08/2008
Last updated
10/19/2018
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