Basic Information
Provider Information
NPI: 1124068762
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARSHAD
FirstName: MUHAMMAD
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 233 W 1ST ST
Address2:  
City: WACONIA
State: MN
PostalCode: 553871302
CountryCode: US
TelephoneNumber: 9524429770
FaxNumber:  
Practice Location
Address1: 7481 WARDEN ROAD
Address2:  
City: SHERWOOD
State: AR
PostalCode: 72120
CountryCode: US
TelephoneNumber: 5019189192
FaxNumber: 5012957679
Other Information
ProviderEnumerationDate: 06/08/2006
LastUpdateDate: 02/27/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XE-3580ARY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
14983100105AR MEDICAID
5M53201ARBLUE CROSS OF AROTHER


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