Organization
VANGUARD MEDICAL ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. K. MUJIB HAQUE M.D. (CEO)
(602) 312-0185
Entity
Organization
Contact information
Practice address
1000 WILLOW CREEK RD, SUITE B, PRESCOTT, AZ 86301-1645
(928) 277-4458
Mailing address
P.O. BOX 10306, PRESCOTT, AZ 86304
(928) 277-4458
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538155379
INDIVIDUAL PROVIDER NPI
AZ
Enumeration date
04/28/2006
Last updated
08/22/2020
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