Organization
APPALACHIAN PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMED MAZUMDER M.D. (PRESIDENT)
(646) 707-7415
Entity
Organization
Contact information
Practice address
92 PICKETT LN, PRESTONSBURG, KY 41653-8569
(606) 874-0112
(606) 874-0115
Mailing address
92 PICKETT LN, PRESTONSBURG, KY 41653-8569
(606) 874-0112
(606) 874-0115
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
43704
KY
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
43704
KY
Other
Enumeration date
02/16/2017
Last updated
03/19/2019
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