Provider Demographics
NPI:1720244734
Name:MUZAFFAR, MAHVISH (MD)
Entity Type:Individual
Prefix:
First Name:MAHVISH
Middle Name:
Last Name:MUZAFFAR
Suffix:
Gender:F
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:PO BOX 8423
Mailing Address - Street 2:NEWCO CANCER SERVICES
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835-8423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 MOYE BLVD
Practice Address - Street 2:LEO JENKINS CANCER SERVICES
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4300
Practice Address - Country:US
Practice Address - Phone:252-744-2900
Practice Address - Fax:252-744-3844
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-01278207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC179VXOtherBCBS NC
NC1720244734Medicaid
NC1720244734Medicaid
NCNCD8170322Medicare PIN