Individual
AMMAR MUSHTAQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 MILITARY HEIGHTS PL, ROSWELL, NM 88201-6407
(575) 627-9500
(575) 627-9535
Mailing address
355 RIDGE AVE, EVANSTON, IL 60202-3328
(847) 316-6228
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2022-1467
NM
390200000X
Student in an Organized Health Care Education/Training Program
125074267
IL
Other
Enumeration date
07/20/2019
Last updated
12/15/2022
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