Provider Demographics
NPI:1255338869
Name:NIAZ, MUHAMMED ARIF (MD)
Entity type:Individual
Prefix:
First Name:MUHAMMED
Middle Name:ARIF
Last Name:NIAZ
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 1:18 BLACKBIRD CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-8625
Mailing Address - Country:US
Mailing Address - Phone:302-731-0861
Mailing Address - Fax:
Practice Address - Street 1:107 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5326
Practice Address - Country:US
Practice Address - Phone:410-392-6408
Practice Address - Fax:410-392-6409
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-29
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0059501207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD401409000Medicaid
MD555MMedicare UPIN