Tayara, Wakkas
Tayara, Wakkas is an individual health care provider with primary practice located at 1391 Broad Ave , Gulfport MS 39501-2419. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Tayara, Wakkas can be contacted via phone (228) 392-7429.Contact Information
Primary practice address
1391 Broad Ave
Gulfport MS 39501-2419
Phone: (228) 392-7429
Fax: (228) 396-3830
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 18677 | Mississippi |
Profile Details
| NPI number | 1710916564 |
|---|---|
| LBN Legal business name | Tayara, Wakkas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 2nd, 2006 |
| Last updated | Jan 14th, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710916564 | NPPES |
| Mississippi | MEDICAID | 00124636 |
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