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Individual

MOHAMMAD Z HOQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1116 N 16TH ST, SUITE A, LAFAYETTE, IN 47904-2119
(765) 448-8000
(765) 448-8054
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
27466
NE
207RI0011X
Interventional Cardiology Physician
Primary
01074113A
IN
207RI0011X
Interventional Cardiology Physician
27466
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000876778
ANTHEM PROVIDER NUMBER
IN
05
201227500
IN
05
5905041
NC
Enumeration date
07/21/2006
Last updated
01/14/2021
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