| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MUNAWAR P. MUMTAZ | 1982762316 | 2024-04-08 |
Munawar P. Mumtaz is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1982762316. Registration indicates Munawar P. Mumtaz is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Family Medicine Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine, Allopathic & Osteopathic Physicians)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Mrs. Munawar P. Mumtaz M.D. |
| Practice Office Address | 9040 JACKSON AVENUE JBLM, WA US |
| Practice Office Telephone | 2539681484 |
| Practice Office Fax | 2539683278 |
| Mailing Address | 9040 JACKSON AVE MADIGAN ARMY MEDICAL CENTER TACOMA, WA 984311100 US |
| Business Telephone | 2539681484 |
| Business Fax | 2539683278 |
| Code | Practice | License No State |
|---|---|---|
| 207Q00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Family MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Family Medicine Allopathic & Osteopathic Physicians Family Medicine Family Medicine Primary Care/Family Planning/APRN/PA Family Medicine Allopathic & Osteopathic Physicians | MD00022972
WA |
| 8146847 | MEDICAID | WA |