Provider Demographics
NPI:1598984791
Name:CHISHTI, WAQAS A (MBBS)
Entity Type:Individual
Prefix:DR
First Name:WAQAS
Middle Name:A
Last Name:CHISHTI
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3810
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64803-3810
Mailing Address - Country:US
Mailing Address - Phone:417-347-8315
Mailing Address - Fax:
Practice Address - Street 1:1111 MCINTOSH CIR
Practice Address - Street 2:SUITE 302
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3645
Practice Address - Country:US
Practice Address - Phone:417-347-8315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010013481207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease