Provider Demographics
NPI:1265873608
Name:AMJAD, MUHAMMAD (PHD)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:AMJAD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 SPRINGDALE RD
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9344
Mailing Address - Country:US
Mailing Address - Phone:304-945-9424
Mailing Address - Fax:304-945-9093
Practice Address - Street 1:2006 SPRINGDALE RD
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9344
Practice Address - Country:US
Practice Address - Phone:304-945-9424
Practice Address - Fax:304-945-9093
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDI 43353291U00000X
NYAMJAM1291U00000X
NJ25MS00014100291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory