Individual
MUHAMMAD EHTISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
371 S BROADVIEW ST, CAPE GIRARDEAU, MO 63703-5761
(573) 331-7830
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LP03485
RI
207RP1001X
Pulmonary Disease Physician
Primary
2021030438
MO
Other
Enumeration date
08/13/2015
Last updated
07/28/2026
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