1043281298 NPI number — DR. NADEEM IQBAL M.D.

Table of content: DR. NADEEM IQBAL M.D. (NPI 1043281298)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043281298 NPI number — DR. NADEEM IQBAL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
IQBAL
Provider First Name:
NADEEM
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043281298
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/13/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3572 BRODHEAD RD
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
MONACA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15061-3101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-728-6539
Provider Business Mailing Address Fax Number:
724-728-7416

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 DUTCH RIDGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEAVER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15009-9727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-773-4567
Provider Business Practice Location Address Fax Number:
724-728-9729
Provider Enumeration Date:
01/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  MD044122L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001258801 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0191886 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3810004776 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0012588010007 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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