Provider Demographics
NPI:1801057252
Name:ALIYU, MUKTAR H (MBBS, MPH, DRPH)
Entity type:Individual
Prefix:DR
First Name:MUKTAR
Middle Name:H
Last Name:ALIYU
Suffix:
Gender:M
Credentials:MBBS, MPH, DRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:615-322-3000
Mailing Address - Fax:
Practice Address - Street 1:1211 21ST AVE S
Practice Address - Street 2:SUITE 640 MAB
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2717
Practice Address - Country:US
Practice Address - Phone:615-936-0955
Practice Address - Fax:615-936-0966
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD446872083P0901X
MN510332083P0901X
MN1038712083P0901X
TN446872083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN840000113Medicare PIN