Basic Information
| Provider Information | |||||||||
| NPI: | 1942205000 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | IKRAM U. HAQUE, MD, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 FRANKLIN ST | ||||||||
| Address2: | STE 210 | ||||||||
| City: | JOHNSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159054330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8145355700 | ||||||||
| FaxNumber: | 8145361786 | ||||||||
| Practice Location | |||||||||
| Address1: | 1111 FRANKLIN ST | ||||||||
| Address2: | STE 210 | ||||||||
| City: | JOHNSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159054330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8145355700 | ||||||||
| FaxNumber: | 8145361786 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HAQUE | ||||||||
| AuthorizedOfficialFirstName: | IKRAM | ||||||||
| AuthorizedOfficialMiddleName: | U. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8145345700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | MD040357E | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.