Active NPI
Khwaja Mujib Haque, MD
- Internal Medicine Physician
- Glendale, AZ
National Provider Identifier
1538155379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 29070
- Practice address
- 17500 N 67TH Ave
Suite 1044
Glendale, AZ 85308-1079 - Phone
- (602) 400-7552
- NPI assigned
- Sep 27, 2005
- Last updated
- Mar 23, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 29070 | AZ | Primary |
Addresses
Primary practice location
17500 N 67TH Ave
Suite 1044
Glendale, AZ 85308-1079
Mailing address
17500 N 67TH Ave
Suite 1044
Glendale, AZ 85308-1079
Phone (602) 400-7552
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29070 | AZ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Naz Hospitalists Inc | Past | Accepting new patients | |
| Ipn of Arizona, PLC | Internal Medicine | Past | Accepting new patients |
| Banner Sun City Medical Group | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Sun City, AZ
- NPI 1902067200
-
dba Inpatient Physicians Network of Arizona
- Internal Medicine Physician
- Glendale, AZ
- NPI 1538119284
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300838400000",
"number": "1538155379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17500 N 67TH AVE",
"address_2": "SUITE 1044",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853081079",
"telephone_number": "602-400-7552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17500 N 67TH AVE",
"address_2": "SUITE 1044",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853081079",
"telephone_number": "602-400-7552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAQUE",
"first_name": "KHWAJA",
"middle_name": "MUJIB",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-27",
"last_updated": "2011-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "29070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.