Provider Demographics
NPI:1831489509
Name:SARWAT A IQBAL MD PC
Entity Type:Organization
Organization Name:SARWAT A IQBAL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARWAT
Authorized Official - Middle Name:AZMA
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-520-9440
Mailing Address - Street 1:4104 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-2614
Mailing Address - Country:US
Mailing Address - Phone:215-223-0200
Mailing Address - Fax:267-319-1769
Practice Address - Street 1:4104 N 5TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-2614
Practice Address - Country:US
Practice Address - Phone:215-223-0200
Practice Address - Fax:267-319-1769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2016-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039666L207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011423861-0001Medicaid
532164OtherMEDICARE ID
PA0011423861-0001Medicaid