Provider Demographics
NPI:1437150125
Name:HAQ, MUHAMMAD I (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:I
Last Name:HAQ
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 1:2055 LIMESTONE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5536
Mailing Address - Country:US
Mailing Address - Phone:302-633-6200
Mailing Address - Fax:302-575-9322
Practice Address - Street 1:2055 LIMESTONE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5536
Practice Address - Country:US
Practice Address - Phone:302-633-6200
Practice Address - Fax:302-575-9322
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC100021412085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000465901Medicaid
DE0000465901Medicaid
DE003828D14Medicare PIN
DE007448B93Medicare PIN
DE007451P97Medicare PIN
DE007449W26Medicare PIN
DE00A572G66Medicare PIN
DE003459B93Medicare PIN
PAD73646Medicare UPIN
DE007577I36Medicare PIN