Individual
MUHAMMAD A MUMTAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
GSMC - HOSPITALISTS, 235 NORTH PEARL ST, BROCKTON, MA 02301-4012
(508) 427-3000
Mailing address
BMCHS PROVIDER ENROLLMENT, 960 MASSACHUSETTS AVE FLR 2, BOS, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
204600
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0025950
NEIGHBORHOOD HEALTH PLAN
—
01
—
35780
HEALTHY START
MA
01
—
J23605
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/17/2006
Last updated
03/14/2025
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