Organization
BAQHAR MOHIDEEN MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAQHAR MOHIDEEN MD (PHYSICIAN-OWNER)
(219) 759-1441
Entity
Organization
Contact information
Practice address
3630 WILLOWCREEK RD, PORTAGE, IN 46368-5075
(219) 759-1441
(219) 738-6714
Mailing address
PO BOX 1485, VALPARAISO, IN 46384-1485
(219) 759-1441
(219) 738-6714
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
01055496
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200356250
—
IN
Enumeration date
12/04/2006
Last updated
06/09/2008
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