Basic Information
| Provider Information | |||||||||
| NPI: | 1841673985 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GHATALA | ||||||||
| FirstName: | MUHAMMED ZOHAIB | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 640 S STATE ST | ||||||||
| Address2: | |||||||||
| City: | DOVER | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199013530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027447581 | ||||||||
| FaxNumber: | 3027447332 | ||||||||
| Practice Location | |||||||||
| Address1: | 8268 164TH ST | ||||||||
| Address2: | N BUILDING, ROOM 740 | ||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114321121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188834847 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2015 | ||||||||
| LastUpdateDate: | 07/30/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | C1-0012718 | DE | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.