Individual
DR. MOHMAD AJAZ UL-HAQ BULBUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
455 SOUTH MAIN STREET, SUITE 202, HINESVILLE, GA 31313-4354
(912) 819-4646
(912) 819-4667
Mailing address
836 E 65TH ST STE 22, SAVANNAH, GA 31405-4493
(912) 819-4646
(912) 819-4667
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A106208
CA
207RH0003X
Hematology & Oncology Physician
Primary
87015
GA
207RH0003X
Hematology & Oncology Physician
MD2012-0091
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000Z2565
MEDICAID GROUP
NM
05
—
003240502A
—
GA
05
—
14130351
—
NM
01
—
19321870448
GROUP NPI
NM
01
—
800521089
MCR GROUP
NM
01
—
CH3451
RAILROAD MEDICARE GROUP
NM
01
—
P01121731
MEDICARE RAILROAD CARRIER
NM
Enumeration date
01/23/2009
Last updated
11/05/2021
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