Provider Demographics
NPI:1750031357
Name:AKHTAR, MOHAMMAD MOIZZ (DO)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:MOIZZ
Last Name:AKHTAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:MOHAMMAD
Other - Middle Name:MOIZZ
Other - Last Name:AKHTAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:2139 AUBURN AVE STE 2170
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2139 AUBURN AVE STE 2170
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-585-4079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program