Individual
DR. MASHFIQ MAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0001
(309) 672-5522
Mailing address
900 MAIN ST, SUITE 720, PEORIA, IL 61602-1005
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125065252
IL
2084P0800X
Psychiatry Physician
Primary
125065252
IL
Other
Enumeration date
06/23/2014
Last updated
09/18/2014
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