| Mosta G Haque Md Pc | |
|
301 Goode Way Suite 201 Portsmouth VA 23704-2266 | |
| (757) 397-0700 | |
| (757) 397-8751 |
| Full Name | Mosta G Haque Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 301 Goode Way, Portsmouth, Virginia |
| Authorized Official Name and Position | Mosta G Haque (PRESIDENT) |
| Authorized Official Contact | 7573970700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosta G Haque Md Pc 301 Goode Way Suite 201 Portsmouth VA 23704-2266 Ph: (757) 397-0700 | Mosta G Haque Md Pc 301 Goode Way Suite 201 Portsmouth VA 23704-2266 Ph: (757) 397-0700 |
| NPI Number | 1578776779 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 02/14/2013 |
| Medicare PECOS PAC ID | 0345264040 |
|---|---|
| Medicare Enrollment ID | O20060120000626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578776779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101-048420 (Virginia) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | 0101-048420 (Virginia) | Primary |
| Provider Name | Mosta Gausel Haque |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1164465639 PECOS PAC ID: 3779507488 Enrollment ID: I20060131000836 |
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