Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 01068447A | IN |
Y | 207RI0011X | Interventional Cardiology | 01068447A | IN |
NPI | 1023053022 |
---|---|
Provider Name | Muhammad Shakil Aslam |
First Address | South Bend, IN 46617-1924 |
Second Address | South Bend, IN 46601-1081 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200987490 | (05) | IN |
H18761 | (02) | |
M400025245 | MEDICARE PTAN (01) | |
M400034563 | MEDICARE PTAN (01) |