Individual
DR. GHULAM MUJTABA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
60 MESSIMER DR, NEWARK, OH 43055-3692
(740) 326-6552
(740) 326-6897
Mailing address
60 MESSIMER DR, NEWARK, OH 43055-3692
(740) 326-6552
(740) 326-6897
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
036144414
IL
207RG0100X
Gastroenterology Physician
Primary
35.097038
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051080
—
OH
Enumeration date
11/02/2007
Last updated
03/17/2018
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