Provider Demographics
NPI:1669466926
Name:YUSUFZAI, HASHIM MOHAMMAD (MD)
Entity type:Individual
Prefix:DR
First Name:HASHIM
Middle Name:MOHAMMAD
Last Name:YUSUFZAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMMAD
Other - Middle Name:HASHIM
Other - Last Name:YUSUFZAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:DUNCAN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:43734-0308
Mailing Address - Country:US
Mailing Address - Phone:740-674-5020
Mailing Address - Fax:740-674-5080
Practice Address - Street 1:488 MAPLE ST
Practice Address - Street 2:
Practice Address - City:DUNCAN FALLS
Practice Address - State:OH
Practice Address - Zip Code:43734-9751
Practice Address - Country:US
Practice Address - Phone:740-674-5020
Practice Address - Fax:740-674-5080
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35053716207Q00000X
VA0101237172207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0631936Medicaid
OH0631936Medicaid
A16500Medicare UPIN