Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 036133368 | IL |
NPI | 1003051871 |
---|---|
Provider Name | Dr. Muhammad Jawad Popalzai |
First Address | Carbondale, IL 62902-3988 |
Second Address | Carterville, IL 62918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2008 |
Last Update Date | 28/09/2021 |