Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | E-4335 | AR |
NPI | 1063526614 |
---|---|
Provider Name | Dr. Abid Mohiuddin |
First Address | Pine Bluff, AR 71603-7836 |
Second Address | Pine Bluff, AR 71603-7836 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 19/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G58363 | (02) |