Provider Demographics
NPI:1891719365
Name:JAMAL, MUHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:JAMAL
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 1:1201 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8428
Mailing Address - Country:US
Mailing Address - Phone:540-368-3700
Mailing Address - Fax:540-741-3348
Practice Address - Street 1:1001 SAM PERRY BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4453
Practice Address - Country:US
Practice Address - Phone:540-741-3340
Practice Address - Fax:540-741-3348
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058255207Q00000X
VA0101250653208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA111887OtherUGS-REIDSVILLE
GA562928286AMedicaid
GA111889OtherUGS-SOPERTON
GA000632376AMedicaid
GA000632376GMedicaid
GA000632376HMedicaid
GA111830OtherUGS-SWAINSBORO
GA111904Medicare Oscar/Certification
WI111904Medicare Oscar/Certification
GA000632376GMedicaid
GA000632376AMedicaid