Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 01052070A | IN |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | ME126314 | FL |
N | 207RC0000X | Internist - Cardiovascular Disease | 01052070A | IN |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 01052070A | IN |
N | 207RC0200X | Critical Care Medicine | 01052070A | IN |
N | 2086S0129X | Vascular Surgeon | 01052070A | IN |
NPI | 1619931516 |
---|---|
Provider Name | Waqas A Ghumman |
First Address | Atlantis, FL 33462-6641 |
Second Address | Atlantis, FL 33462-6641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 10/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200375660 | (05) | IN |
P01214639 | RR MEDICARE PTAN (01) | IN |