Provider Demographics
NPI:1174841035
Name:MUNSHI, MOHAMED KHALID (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED KHALID
Middle Name:
Last Name:MUNSHI
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 1:6700 KIRKVILLE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9313
Mailing Address - Country:US
Mailing Address - Phone:315-277-2707
Mailing Address - Fax:315-433-5100
Practice Address - Street 1:6700 KIRKVILLE RD STE 203
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9313
Practice Address - Country:US
Practice Address - Phone:315-277-2707
Practice Address - Fax:315-433-5100
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288105207RI0011X, 207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease