Provider Demographics
NPI:1255345898
Name:MIAN, MUHAMMAD S (MD)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:S
Last Name:MIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2345 CHESTERFIELD AVE 202
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1063
Mailing Address - Country:US
Mailing Address - Phone:304-346-2284
Mailing Address - Fax:304-346-6590
Practice Address - Street 1:2335 CHESTERFIELD AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1066
Practice Address - Country:US
Practice Address - Phone:304-346-2284
Practice Address - Fax:304-346-7470
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WVWV17288207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0044715000Medicaid
WV0953AMedicare PIN
WVE15266Medicare UPIN
WVMI4031636Medicare ID - Type Unspecified