Provider Demographics
NPI:1295389369
Name:FURQAN, MUHAMMAD (RPH)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:FURQAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-5227
Mailing Address - Country:US
Mailing Address - Phone:401-644-1467
Mailing Address - Fax:
Practice Address - Street 1:57 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-5227
Practice Address - Country:US
Practice Address - Phone:401-644-1467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-28
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH238857183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist