Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | ME 98421 | FL |
NPI | 1619196185 |
---|---|
Provider Name | Dr. Khader Muqtadir |
First Address | Tampa, FL 33613-3998 |
Second Address | Tampa, FL 33613-3998 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 24/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01372 | BCBSFL (01) | FL |
161339600 | DOL (01) | FL |