Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 52180 | TN |
N | 111NI0900X | Internist | 52180 | TN |
N | 207R00000X | Internist | A108371 | CA |
N | 111NI0900X | Internist | A108371 | CA |
N | 207RC0200X | Critical Care Medicine | 52180 | TN |
Y | 207RP1001X | Pulmonary Disease | 52180 | TN |
NPI | 1003043043 |
---|---|
Provider Name | Khawaja Muhammad Muddassir |
First Address | Memphis, TN 38148-0001 |
Second Address | Memphis, TN 38104-3519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2009 |
Last Update Date | 09/11/2016 |