Individual
DR. ALI MUSTAFA BAJWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3156
Mailing address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3156
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.130480
IL
207Q00000X
Family Medicine Physician
P1265
TX
Other
Enumeration date
07/28/2008
Last updated
11/05/2014
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