Individual
DR. HUMAYUN BAKHTAWAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5010
(601) 579-3067
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5010
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
23480
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06609743
—
MS
Enumeration date
06/28/2007
Last updated
07/09/2020
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