Mumtaz, Syed R.

Mumtaz, Syed R. is an individual health care provider with primary practice located at 909 E State Blvd , Fort Wayne IN 46805-3404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Mumtaz, Syed R. can be contacted via phone (260) 481-2700.

Contact Information

Primary practice address
909 E State Blvd Fort Wayne IN 46805-3404
Phone: (260) 481-2700
Fax: (260) 481-2717
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 01049582A Indiana

Profile Details

NPI number 1396718573
LBN Legal business name Mumtaz, Syed R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Apr 23rd, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396718573 NPPES
Indiana MEDICAID 200224110

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