Individual
M AZAM MOHIUDDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
8110 BUSTLETON AVE, PHILADELPHIA, PA 19152-2803
(215) 695-0331
(215) 695-0325
Mailing address
8110 BUSTLETON AVE, PHILADELPHIA, PA 19152-2803
(215) 695-0331
(215) 695-0325
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD037150L
PA
283Q00000X
Psychiatric Hospital
MD-037150L
PA
Other
Enumeration date
08/31/2006
Last updated
02/15/2008
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