Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01083181A | IN |
N | 111NI0900X | Internist | 01083181A | IN |
N | 207RC0000X | Internist - Cardiovascular Disease | 01083181A | IN |
N | 207RC0000X | Internist - Cardiovascular Disease | 2010034777 | MO |
N | 207RC0000X | Internist - Cardiovascular Disease | 201401140 | NC |
Y | 207RC0000X | Internist - Cardiovascular Disease | 57198 | WI |
N | 207RC0000X | Internist - Cardiovascular Disease | E-5331 | AR |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 01083181A | IN |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 036.142165 | IL |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 036142165 | IL |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 201401140 | NC |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 57198-20 | WI |
NPI | 1053536078 |
---|---|
Provider Name | Muhammad R Marwali |
First Address | Morris, IL 60450-1207 |
Second Address | Morris, IL 60450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 02/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036.142165 | IL LICENSE (01) | IL |
336.103555 | CDS (01) | IL |
FM4423620 | DEA (01) | IL |