Provider Demographics
NPI:1740248145
Name:MUKHTAR, MUHAMMAD AMJAD (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:AMJAD
Last Name:MUKHTAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 REGAL CT
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-4735
Mailing Address - Country:US
Mailing Address - Phone:412-672-9000
Mailing Address - Fax:412-672-9050
Practice Address - Street 1:1801 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:WHITE OAK
Practice Address - State:PA
Practice Address - Zip Code:15131-1724
Practice Address - Country:US
Practice Address - Phone:412-672-9000
Practice Address - Fax:412-672-9050
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD057971L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA892481Medicare ID - Type Unspecified