Provider Demographics
NPI:1801236807
Name:ISHFAQ, MUHAMMAD (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:
Last Name:ISHFAQ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1643 NW 136TH AVE BLDG H
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2857
Mailing Address - Country:US
Mailing Address - Phone:865-500-1345
Mailing Address - Fax:865-560-7110
Practice Address - Street 1:2135 DENTON DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-3103
Practice Address - Country:US
Practice Address - Phone:321-799-7111
Practice Address - Fax:865-560-7110
Is Sole Proprietor?:No
Enumeration Date:2013-07-05
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME116810207R00000X, 208M00000X
TXQ0941207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist