1174687248 NPI number — MOHIUDDIN CHEEMA M.D.

Table of content: MOHIUDDIN CHEEMA M.D. (NPI 1174687248)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174687248 NPI number — MOHIUDDIN CHEEMA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHEEMA
Provider First Name:
MOHIUDDIN
Provider Middle Name:
Provider Name Prefix Text:
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:
1174687248
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
85 SEYMOUR ST
Provider Second Line Business Mailing Address:
SUITE 409
Provider Business Mailing Address City Name:
HARTFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06106-5501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-522-4158
Provider Business Mailing Address Fax Number:
860-524-2652

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
85 SEYMOUR ST
Provider Second Line Business Practice Location Address:
SUITE 409
Provider Business Practice Location Address City Name:
HARTFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06106-5501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-522-4158
Provider Business Practice Location Address Fax Number:
860-524-2652
Provider Enumeration Date:
12/21/2006

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: 2085R0204X , with the licence number:  044001 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 044001 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208G00000X , with the licence number: 044001 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086S0129X , with the licence number: 044001 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 010044001CT01 . This is a "ANTHEM BCBS AND BCFP" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "COMMUNITY HEALTH NETWORK" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "MULTIPLAN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "GREAT WEST" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 441960 . This is a "WELLCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "PRIVATE HEALTHCARE SYSTEM" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 001440015 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 06-1406459 . This is a "TRICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "PIONEER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "NORTHEAST HEALTH DIRECT" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "FOCUS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2V9398 . This is a "HEALTH NET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 7974948 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "HEALTH NEW ENGLAND" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "CORVEL" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0601175 . This is a "CIGNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 044001 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P3819088 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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