Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 01063451A | IN |
Y | 111NI0900X | Internist | 01063451A | IN |
N | 207R00000X | Internist | 36658 | KY |
N | 111NI0900X | Internist | 36658 | KY |
N | 207RG0300X | Geriatric Medicine | 01063451A | IN |
N | 207RG0300X | Geriatric Medicine | 36658 | KY |
NPI | 1043216971 |
---|---|
Provider Name | Muhammad I Masroor |
First Address | Jeffersonville, IN 47130-4494 |
Second Address | Jeffersonville, IN 47130-4494 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 20/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200920270 | (05) | IN |
64052954 | (05) | KY |
H68356 | (02) |