Provider Demographics
NPI:1316230642
Name:IMRAN UL HAQ,M.D., LLC
Entity Type:Organization
Organization Name:IMRAN UL HAQ,M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IMRAN
Authorized Official - Middle Name:U
Authorized Official - Last Name:HAQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-558-3323
Mailing Address - Street 1:211 SHIVERS RUN CT
Mailing Address - Street 2:MULLICA HILL
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-4731
Mailing Address - Country:US
Mailing Address - Phone:856-558-3323
Mailing Address - Fax:
Practice Address - Street 1:1 WHEATLEY BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-9622
Practice Address - Country:US
Practice Address - Phone:856-558-3323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty