Individual
DR. MUBASHIR AHMED MUMTAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 S FRONT STREET, 4TH FL, BMA, HARRISBURG, PA 17104-1619
(717) 231-8555
(717) 231-8568
Mailing address
409 S 2ND ST, SUITE 2F, HARRISBURG, PA 17104-1612
(717) 231-8555
(717) 231-8568
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD421279
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101220727
—
PA
05
—
102446264
—
PA
Enumeration date
05/01/2006
Last updated
01/25/2021
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