Provider Demographics
NPI:1023004587
Name:ASGAR, MOHAMMED (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:
Last Name:ASGAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5490 BROADWAY STE 106
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-1676
Mailing Address - Country:US
Mailing Address - Phone:219-939-7130
Mailing Address - Fax:219-951-0883
Practice Address - Street 1:5490 BROADWAY STE 106
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-1676
Practice Address - Country:US
Practice Address - Phone:219-939-7130
Practice Address - Fax:219-951-0883
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-092203207R00000X
IN01068370A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-092-203Medicaid
ILG53480Medicare UPIN
IL036-092-203Medicaid