Provider Demographics
NPI:1255508149
Name:ATHAR, MUHAMMAD WAQAS (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:WAQAS
Last Name:ATHAR
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 1:10506A MONTGOMERY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4402
Mailing Address - Country:US
Mailing Address - Phone:513-246-2400
Mailing Address - Fax:513-246-4047
Practice Address - Street 1:10506A MONTGOMERY RD STE 300
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4402
Practice Address - Country:US
Practice Address - Phone:513-246-2400
Practice Address - Fax:513-246-4047
Is Sole Proprietor?:No
Enumeration Date:2008-05-11
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD72498207R00000X
OH35.130616207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD043858800Medicaid
OH0231531Medicaid