Provider Demographics
NPI:1811994411
Name:CHUGHTAI, MUBASHAR
Entity type:Individual
Prefix:
First Name:MUBASHAR
Middle Name:
Last Name:CHUGHTAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:DUQUESNE
Mailing Address - State:PA
Mailing Address - Zip Code:15110-1011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:424 GRANT AVE
Practice Address - Street 2:
Practice Address - City:DUQUESNE
Practice Address - State:PA
Practice Address - Zip Code:15110-1011
Practice Address - Country:US
Practice Address - Phone:412-469-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039578L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA042359OtherAETNA US HEALTHCARE PLAN
PA102901OtherUPMC HEALTH PLANS
PA34601OtherHEALTH ASSURANCE
PAPO02272Medicaid
PA010014643OtherAETNA
PAWAE69OtherADVANTRA HEALTH PLAN
PA059750OtherHIGHMARK BLUE SHIELD
PA059750OtherKEYSTONE HEALTH PLAN WEST
PA102901Medicaid
PA34601OtherHEALTH AMERICA
PA0010228440001Medicaid
PA34601OtherHEALTH ASSURANCE
PA059570Medicare PIN