Individual
IRFAN M HISAMUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4745 OGLETOWN STANTON RD, SUITE 134, NEWARK, DE 19713-2067
(302) 738-5300
(302) 731-4822
Mailing address
PO BOX 7356, LANCASTER, PA 17604-7356
(410) 441-4847
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PENDING
MD
207RG0100X
Gastroenterology Physician
C1-0011248
DE
Other
Enumeration date
06/15/2007
Last updated
07/22/2015
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