Provider Demographics
NPI:1265670251
Name:GHUMMAN, MUHAMMAD S (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:S
Last Name:GHUMMAN
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 1:1717 N E ST STE 331
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-6335
Mailing Address - Country:US
Mailing Address - Phone:850-484-6500
Mailing Address - Fax:850-857-1747
Practice Address - Street 1:1717 N E ST STE 331
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501
Practice Address - Country:US
Practice Address - Phone:850-484-6500
Practice Address - Fax:850-857-1747
Is Sole Proprietor?:No
Enumeration Date:2009-01-28
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME132606207RI0011X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL203162Medicaid
FL021127200Medicaid