Individual
DR. FAWZIA HAQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4133 MEDICAL CENTER DR, BROAD TOP, PA 16621-9001
(814) 506-8463
Mailing address
4133 MEDICAL CENTER DR, BROAD TOP, PA 16621-9001
(814) 506-8463
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD431772
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118607WFP
MEDICARE PTAN
PA
Enumeration date
10/18/2007
Last updated
06/06/2024
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