Ghulam Mustafa LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

29210 Issued in AZ

Legal business name

GHULAM MUSTAFA LLC

Practice address

2401 E Hunt Dr
Show Low, AZ 85901-7920

Phone

(928) 537-5333

Fax

(928) 537-1762

NPI assigned

Jan 22, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Osaf Ahmed, MDNPI 1396775680

Title

Member

Phone

(520) 269-3473

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Osaf Ahmed, MD

  • Internal Medicine Physician
  • Chandler, AZ
  • NPI 1396775680
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516579200000",
    "number": "1477061612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6989 N STARLIGHT RIDGE PKWY",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859295086",
            "telephone_number": "520-269-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 E HUNT DR",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017920",
            "telephone_number": "928-537-5333",
            "fax_number": "928-537-1762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHULAM MUSTAFA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-22",
        "last_updated": "2018-01-22",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "OSAF",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "520-269-3473",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "29210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "29210",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jody Marie Gaskill, LAC
• Rod E Genck, PA
• Genoa Healthcare LLC
• German Dobson CVS LLC
• German Dobson CVS LLC
• Laura Rennie Gibson, CNM
• Kenneth A Giles, MD
• William Gonzalez, L.C.S.W.
• Brian William Goodman, DO
• Katrine Gordon, PT

• Internal Medicine Physician in Show Low, AZ
• Providers in Show Low, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.