Doctor Name: | MIAN MUSHTAQ |
NPI Number: | 1043266174 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 01047786A |
Business Practice Address: | 301 Gordon Gutmann Blvd Ste 301 Jeffersonville, IN - 471303764 |
Business Phone Number: | 8122889969 |
Business Fax Number: | 8122889657 |
Mailing Address: | 315 E Broadway, LOUISVILLE |
State: | KY |
Postal Code: | 402023700 |
Phone Number: | 5026292500 |
Fax Number: | 5026292055 |
NPI Enumeration Date: | 05/26/2006 |
NPI Last Update Date: | 02/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207RH0003X |
License Number: | 01047786A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Internal Medicine |
Taxonomy Specialization: | Hematology & Oncology |
Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |