Provider Demographics
NPI:1851775753
Name:MUKHTAR, OSAMA M (MD)
Entity Type:Individual
Prefix:DR
First Name:OSAMA
Middle Name:M
Last Name:MUKHTAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2055 W HOSPITAL DR STE 205
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7822
Mailing Address - Country:US
Mailing Address - Phone:520-575-6944
Mailing Address - Fax:520-575-1115
Practice Address - Street 1:2055 W HOSPITAL DR STE 205
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7822
Practice Address - Country:US
Practice Address - Phone:520-575-6944
Practice Address - Fax:520-575-1115
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2023-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN66577207RC0200X
AZ66400207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine