Provider Demographics
NPI:1073580783
Name:IDREES, MUHAMMAD S (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:S
Last Name:IDREES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:43 BATAVIA CITY CTR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-2146
Mailing Address - Country:US
Mailing Address - Phone:585-343-7117
Mailing Address - Fax:585-343-3783
Practice Address - Street 1:43 BATAVIA CITY CTR
Practice Address - Street 2:SUITE A
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2146
Practice Address - Country:US
Practice Address - Phone:585-343-7117
Practice Address - Fax:585-343-3783
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0010262080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP03001026OtherBLUE CROSS OF ROCHESTER
NY103440DLOtherPREFERRED CARE
NY00525878003OtherBC OF WNY
NY02047423Medicaid
NYP010001026OtherBLUE CHOICE OF ROCHESTER
NY1210879OtherINDEPENDENT HEALTH