Provider Demographics
NPI:1912074774
Name:M S HAQ MD PC
Entity Type:Organization
Organization Name:M S HAQ MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:S
Authorized Official - Last Name:HAQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-762-1331
Mailing Address - Street 1:11050 BUCHANAN TRAIL EAST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-1643
Mailing Address - Country:US
Mailing Address - Phone:717-762-1331
Mailing Address - Fax:717-762-0702
Practice Address - Street 1:11050 BUCHANAN TRAIL EAST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-1643
Practice Address - Country:US
Practice Address - Phone:717-762-1331
Practice Address - Fax:717-762-0702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
023697Medicare ID - Type Unspecified